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Natural history of monoclonal B-cell lymphocytosis among relatives in CLL families.

Publication ,  Journal Article
Slager, SL; Lanasa, MC; Marti, GE; Achenbach, SJ; Camp, NJ; Abbasi, F; Kay, NE; Vachon, CM; Cerhan, JR; Johnston, JB; Call, TG; Rabe, KG ...
Published in: Blood
April 15, 2021

Chronic lymphocytic lymphoma (CLL) has one of the highest familial risks among cancers. Monoclonal B-cell lymphocytosis (MBL), the precursor to CLL, has a higher prevalence (13%-18%) in families with 2 or more members with CLL compared with the general population (5%-12%). Although, the rate of progression to CLL for high-count MBLs (clonal B-cell count ≥500/µL) is ∼1% to 5%/y, no low-count MBLs have been reported to progress to date. We report the incidence and natural history of MBL in relatives from CLL families. In 310 CLL families, we screened 1045 relatives for MBL using highly sensitive flow cytometry and prospectively followed 449 of them. MBL incidence was directly age- and sex-adjusted to the 2010 US population. CLL cumulative incidence was estimated using Kaplan-Meier survival curves. At baseline, the prevalence of MBL was 22% (235/1045 relatives). After a median follow-up of 8.1 years among 449 relatives, 12 individuals progressed to CLL with a 5-year cumulative incidence of 1.8%. When considering just the 139 relatives with low-count MBL, the 5-year cumulative incidence increased to 5.7%. Finally, 264 had no MBL at baseline, of whom 60 individuals subsequently developed MBL (2 high-count and 58 low-count MBLs) with an age- and sex-adjusted incidence of 3.5% after a median of 6 years of follow-up. In a screening cohort of relatives from CLL families, we reported progression from normal-count to low-count MBL to high-count MBL to CLL, demonstrating that low-count MBL precedes progression to CLL. We estimated a 1.1% annual rate of progression from low-count MBL, which is in excess of that in the general population.

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Published In

Blood

DOI

EISSN

1528-0020

Publication Date

April 15, 2021

Volume

137

Issue

15

Start / End Page

2046 / 2056

Location

United States

Related Subject Headings

  • Pedigree
  • Middle Aged
  • Male
  • Lymphocytosis
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Kaplan-Meier Estimate
  • Incidence
  • Immunology
  • Humans
  • Female
 

Citation

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Slager, S. L., Lanasa, M. C., Marti, G. E., Achenbach, S. J., Camp, N. J., Abbasi, F., … Caporaso, N. E. (2021). Natural history of monoclonal B-cell lymphocytosis among relatives in CLL families. Blood, 137(15), 2046–2056. https://doi.org/10.1182/blood.2020006322
Slager, Susan L., Mark C. Lanasa, Gerald E. Marti, Sara J. Achenbach, Nicola J. Camp, Fatima Abbasi, Neil E. Kay, et al. “Natural history of monoclonal B-cell lymphocytosis among relatives in CLL families.Blood 137, no. 15 (April 15, 2021): 2046–56. https://doi.org/10.1182/blood.2020006322.
Slager SL, Lanasa MC, Marti GE, Achenbach SJ, Camp NJ, Abbasi F, et al. Natural history of monoclonal B-cell lymphocytosis among relatives in CLL families. Blood. 2021 Apr 15;137(15):2046–56.
Slager, Susan L., et al. “Natural history of monoclonal B-cell lymphocytosis among relatives in CLL families.Blood, vol. 137, no. 15, Apr. 2021, pp. 2046–56. Pubmed, doi:10.1182/blood.2020006322.
Slager SL, Lanasa MC, Marti GE, Achenbach SJ, Camp NJ, Abbasi F, Kay NE, Vachon CM, Cerhan JR, Johnston JB, Call TG, Rabe KG, Kleinstern G, Boddicker NJ, Norman AD, Parikh SA, Leis JF, Banerji V, Brander DM, Glenn M, Ferrajoli A, Curtin K, Braggio E, Shanafelt TD, McMaster ML, Weinberg JB, Hanson CA, Caporaso NE. Natural history of monoclonal B-cell lymphocytosis among relatives in CLL families. Blood. 2021 Apr 15;137(15):2046–2056.

Published In

Blood

DOI

EISSN

1528-0020

Publication Date

April 15, 2021

Volume

137

Issue

15

Start / End Page

2046 / 2056

Location

United States

Related Subject Headings

  • Pedigree
  • Middle Aged
  • Male
  • Lymphocytosis
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Kaplan-Meier Estimate
  • Incidence
  • Immunology
  • Humans
  • Female