PMID- 19015397
OWN - NLM
STAT- MEDLINE
DCOM- 20090602
LR  - 20211020
IS  - 1528-0020 (Electronic)
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 113
IP  - 18
DP  - 2009 Apr 30
TI  - B-cell count and survival: differentiating chronic lymphocytic leukemia from 
      monoclonal B-cell lymphocytosis based on clinical outcome.
PG  - 4188-96
LID - 10.1182/blood-2008-09-176149 [doi]
AB  - The diagnosis of chronic lymphocytic leukemia (CLL) in asymptomatic patients has 
      historically been based on documenting a characteristic lymphocyte clone and the 
      presence of lymphocytosis. There are minimal data regarding which lymphocyte 
      parameter (absolute lymphocyte count [ALC] or B-cell count) and what threshold 
      should be used for diagnosis. We analyzed the relationship of ALC and B-cell 
      count with clinical outcome in 459 patients with a clonal population of CLL 
      phenotype to determine (1) whether the CLL diagnosis should be based on ALC or 
      B-cell count, (2) what lymphocyte threshold should be used for diagnosis, and (3) 
      whether any lymphocyte count has independent prognostic value after accounting 
      for biologic/molecular prognostic markers. B-cell count and ALC had similar value 
      for predicting treatment-free survival (TFS) and overall survival as continuous 
      variables, but as binary factors, a B-cell threshold of 11 x 10(9)/L best 
      predicted survival. B-cell count remained an independent predictor of TFS after 
      controlling for ZAP-70, IGHV, CD38, or fluorescence in situ hybridization (FISH) 
      results (all P < .001). These analyses support basing the diagnosis of CLL on 
      B-cell count and retaining the size of the B-cell count in the diagnostic 
      criteria. Using clinically relevant criteria to distinguish between monoclonal 
      B-cell lymphocytosis (MBL) and CLL could minimize patient distress caused by 
      labeling asymptomatic people at low risk for adverse clinical consequences as 
      having CLL.
FAU - Shanafelt, Tait D
AU  - Shanafelt TD
AD  - Mayo Clinic, Rochester, MN, USA. shanafelt.tait@mayo.edu
FAU - Kay, Neil E
AU  - Kay NE
FAU - Jenkins, Greg
AU  - Jenkins G
FAU - Call, Timothy G
AU  - Call TG
FAU - Zent, Clive S
AU  - Zent CS
FAU - Jelinek, Diane F
AU  - Jelinek DF
FAU - Morice, William G
AU  - Morice WG
FAU - Boysen, Justin
AU  - Boysen J
FAU - Zakko, Liam
AU  - Zakko L
FAU - Schwager, Susan
AU  - Schwager S
FAU - Slager, Susan L
AU  - Slager SL
FAU - Hanson, Curtis A
AU  - Hanson CA
LA  - eng
GR  - K23 CA113408/CA/NCI NIH HHS/United States
GR  - R01 CA136591/CA/NCI NIH HHS/United States
GR  - CA 113408/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20081117
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Immunoglobulin Heavy Chains)
SB  - IM
CIN - Blood. 2009 Apr 30;113(18):4130-1. PMID: 19406995
MH  - Aged
MH  - B-Lymphocytes/*pathology
MH  - Biomarkers, Tumor/genetics/metabolism
MH  - Diagnosis, Differential
MH  - Female
MH  - Flow Cytometry
MH  - Humans
MH  - Immunoglobulin Heavy Chains/genetics
MH  - In Situ Hybridization, Fluorescence
MH  - Leukemia, Lymphocytic, Chronic, B-Cell/*diagnosis/*mortality/therapy
MH  - Lymphocyte Count
MH  - Lymphocytosis/*diagnosis/*mortality/therapy
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Reverse Transcriptase Polymerase Chain Reaction
MH  - Survival Rate
MH  - Treatment Outcome
PMC - PMC2676080
EDAT- 2008/11/19 09:00
MHDA- 2009/06/03 09:00
PMCR- 2010/04/30
CRDT- 2008/11/19 09:00
PHST- 2008/11/19 09:00 [pubmed]
PHST- 2009/06/03 09:00 [medline]
PHST- 2008/11/19 09:00 [entrez]
PHST- 2010/04/30 00:00 [pmc-release]
AID - S0006-4971(20)39228-4 [pii]
AID - 2008/176149 [pii]
AID - 10.1182/blood-2008-09-176149 [doi]
PST - ppublish
SO  - Blood. 2009 Apr 30;113(18):4188-96. doi: 10.1182/blood-2008-09-176149. Epub 2008 
      Nov 17.