Chronic Lymphocytic Leukemia With Two B-Cell Populations of Discordant Light Chain Restrictions in Individual Patients: Parallel Development of Biclonal B-Cell Neoplasms or Clonal Evolution With Isotype Switch?
| Autor: | Yue Zhao, Imran Siddiqi, Tyler J Wildes, Jenna McCracken, Kristen Deak, Catherine Rehder, Endi Wang |
|---|---|
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | American Journal of Clinical Pathology. 159:337-351 |
| ISSN: | 1943-7722 0002-9173 |
| Popis: | Objectives To evaluate clinicopathologic characteristics of biclonal chronic lymphocytic leukemia (CLL). Methods Retrospectively analyze clinical data and pathologic features. Results Ten cases were identified in which flow cytometry demonstrated an abnormal B-cell population with a CLL-like immunophenotype but showed no definitive light chain restriction. All had cytogenetic abnormalities detected, including seven with two CLL-related abnormalities. Four of these showed features suggestive of clonal evolution, all having del(13q) as a “stem-line” abnormality and three showing del(11q) as a “side-line” abnormality. Five (50%) cases demonstrated deleterious NOTCH1 mutations, in contrast to 11.8% in a control group of monoclonal CLL (P Conclusions Despite a polytypic pattern of light chain expression, the neoplastic nature of biclonal CLL is suggested by a characteristic CLL phenotype and can be confirmed by cytogenetic and genomic analyses. The two clones with discordant light chain isotypes may share a “stem-line” cytogenetic abnormality, suggesting possible clonal evolution. Biclonal CLL is associated with NOTCH1 mutations, which may occur in a small subclone and gradually evolve in clonal size. Genomic analysis on light chain–sorted and/or chronologically collected samples may provide insight into clonal evolution in CLL. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|