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Impact of B-cell count and imaging screening in cMBL: any need to revise the current guidelines?

Leukemia volume 26, pages 1703–1707 (2012)Cite this article

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Thanks to the widespread availability of multiparameter flow cytometry, >70% of patients affected by chronic lymphocytic leukemia (CLL)1 are currently diagnosed in Rai stage 0. Accordingly, a new entity, called monoclonal B-cell lymphocytosis (MBL), has been identified2, 3 when a smaller clonal B-cell population is detected in the peripheral blood of otherwise healthy subjects. A value of <5 × 109 clonal B cells/l and the absence of palpable lymphadenopathy and/or organomegaly are the currently applied criteria to differentiate MBL from CLL/small lymphocytic lymphoma (SLL).2, 3, 4 It is now evident that CLL-like MBL represents a melting pot category as it includes very different entities5 ranging from tiny clonal B-cell populations detected through general population studies6, 7, 8 to larger B-cell expansions getting medical attention after the detection of lymphocytosis (recently defined as clinical MBL, cMBL).7, 8, 9, 10, 11, 12, 13

Large follow-up studies demonstrated that cMBL carries a risk of progression into CLL requiring treatment of about 1–4% per year, the occurrence of SLL being the most frequent disease evolution, detected in 15% of MBL cases.7, 10, 11

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Acknowledgements

This project was supported by the Associazione Italiana per la Ricerca sul Cancro - AIRC, Milano (Special Program Molecular Clinical Oncology – 5 per mille #9965 and Investigator grants to AN and PG); Progetti di Ricerca di Interesse Nazionale, MIUR, Roma, Italy; Progetto Integrato Oncologia, Ministero della Salute, Roma, Italy; and Fondazione CARIPLO, Milano, Italy.

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Authors and Affiliations

  1. Division of Molecular Oncology, Laboratory of B cell Neoplasia, Istituto Scientifico San Raffaele, Milano, Italy

    L Scarfò & P Ghia

  2. Department of Onco-Hematology, Lymphoma Unit, Istituto Scientifico San Raffaele, Milano, Italy

    L Scarfò & P Ghia

  3. Institute of Hematology, Università degli Studi di Ferrara, Ferrara, Italy

    L Scarfò

  4. Department of Onco-Hematology, Hematology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    S Zibellini & E Orlandi

  5. Department of Oncology/Hematology, Division of Hematology, Niguarda Ca' Granda Hospital, Milano, Italy

    A Tedeschi & M Montillo

  6. Dipartimento di Scienze Mediche Università di Milano, Ematologia 1-CTMO, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico, Milano, Italy

    F Maura, A Neri & A Cortelezzi

  7. Division of Hematoncology, Istituto Europeo di Oncologia, Milano, Italy

    P Bertazzoni

  8. Department of Onco-Hematology, Istituto Clinico Humanitas, Milano, Italy

    B Sarina

  9. Department of Internal Medicine, Presidio Ospedaliero di Lodi, Lodi, Italy

    G Nalli

  10. Division of Hematology, Spedali Civili, Brescia, Italy

    M Motta

  11. Divisione di Ematologia e Centro TMO, Ospedale San Gerardo, Monza, Italy

    F Rossini

  12. Università Vita-Salute San Raffaele and Istituto Scientifico San Raffaele, Milano, Italy

    P Ghia

  13. MAGIC (Microenvironment and Genes in Cancers of the blood) Interdivisional Research Program, Istituto Scientifico San Raffaele, Milano, Italy

    P Ghia

Authors
  1. L Scarfò
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  2. S Zibellini
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  6. P Bertazzoni
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  7. B Sarina
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  8. G Nalli
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  9. M Motta
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  10. F Rossini
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  11. A Cortelezzi
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  12. M Montillo
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  13. E Orlandi
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  14. P Ghia
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on behalf of Rete Ematologica Lombarda (REL)– CLL workgroup

Corresponding author

Correspondence to M Montillo.

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The authors declare no conflict of interest.

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Scarfò, L., Zibellini, S., Tedeschi, A. et al. Impact of B-cell count and imaging screening in cMBL: any need to revise the current guidelines?. Leukemia 26, 1703–1707 (2012). https://doi.org/10.1038/leu.2012.20

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