Journal article
Natural history of monoclonal B-cell lymphocytosis among relatives in CLL families
Blood, Vol.137(15), pp.2046-2056
04/15/2021
DOI: 10.1182/blood.2020006322
PMCID: PMC8057266
PMID: 33512457
Abstract
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.
Details
- Title: Subtitle
- Natural history of monoclonal B-cell lymphocytosis among relatives in CLL families
- Creators
- Susan L Slager - Mayo ClinicMark C Lanasa - Duke UniversityGerald E Marti - National Heart Lung and Blood InstituteSara J Achenbach - Mayo ClinicNicola J Camp - Huntsman Cancer InstituteFatima Abbasi - Center for Biologics Evaluation and ResearchNeil E Kay - Mayo ClinicCeline M Vachon - Mayo ClinicJames R Cerhan - Mayo ClinicJames B Johnston - Research Institute in Oncology and HematologyTimothy G Call - Mayo ClinicKari G Rabe - Mayo ClinicGeffen Kleinstern - Mayo ClinicNicholas J Boddicker - Mayo ClinicAaron D Norman - Mayo ClinicSameer A Parikh - Mayo ClinicJose F Leis - Mayo ClinicVersha Banerji - Research Institute in Oncology and HematologyDanielle M Brander - Duke UniversityMartha Glenn - Huntsman Cancer InstituteAlessandra Ferrajoli - The University of Texas MD Anderson Cancer CenterKaren Curtin - Huntsman Cancer InstituteEsteban Braggio - Department of Hematology and Oncology, Mayo Clinic, Phoenix, AZTait D Shanafelt - Stanford UniversityMary L McMaster - National Institutes of HealthJ Brice Weinberg - Durham VA Medical CenterCurtis A Hanson - Department of Laboratory Medicine and Pathology Mayo Clinic Rochester MNNeil E Caporaso - National Institutes of Health
- Resource Type
- Journal article
- Publication Details
- Blood, Vol.137(15), pp.2046-2056
- DOI
- 10.1182/blood.2020006322
- PMID
- 33512457
- PMCID
- PMC8057266
- ISSN
- 0006-4971
- eISSN
- 1528-0020
- Grant note
- P30 CA042014 / NCI NIH HHS UL1 TR002538 / NCATS NIH HHS P30 CA015083 / NCI NIH HHS
- Language
- English
- Date published
- 04/15/2021
- Academic Unit
- Epidemiology
- Record Identifier
- 9984368088602771
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