Format

Send to:

Choose Destination
See comment in PubMed Commons below
Med Clin (Barc). 2011 May 14;136(13):565-73. doi: 10.1016/j.medcli.2010.09.048. Epub 2011 Mar 10.

[Persistent polyclonal B-cell lymphocytosis: study of 35 cases].

[Article in Spanish]

Author information

  • 1Laboratori de Citologia Hematològica, Servei de Patologia, Hospital del Mar, Barcelona, España. lflorensa@imas.imim.es

Abstract

BACKGROUND AND OBJECTIVES:

Persistent polyclonal B-cell lymphocytosis (PPBL) is a rare entity, presenting especially in adult smoker women. It is characterized by an increase of serum IgM, DR7-HLA haplotype, cytogenetic abnormalities and multiple IgH/BCL-2 rearrangements. To date, it has not been elucidated whether this is a benign or premalignant disorder. We analyzed the PPBL characteristics with especial attention to its evolution.

PATIENTS AND METHODS:

Thirty-five PPBL patients from 5 hospitals in Catalonia were retrospectively analyzed. A simultaneous morphologic review of the blood smears was performed by members of the GCCH in a 16 multiple-observer optic microscope. Clinical and biological data were also analyzed.

RESULTS:

PPBL presents in the majority of cases with persistent polyclonal B-cell lymphocytosis and affects primarily smoker women. The morphologic hallmark, in absence of viral infections, is the presence of activated lymphocytes with bilobulated and/or cleaved nuclei, and nuclear pockets in the ultrastructural study. Increased serum IgM, HLA-DR7 haplotype, chromosomal abnormalities such as i(3)(q10) and multiple IgH/BCL-2 rearrangements were detected. Thirty-four out of 35 patients are alive after a median follow up of 70.7 months. One patient died because of lung adenocarcinoma and another developed a follicular lymphoma without relation to PPBL.

CONCLUSIONS:

PPBL has an asymptomatic and stable evolution, although it frequently presents genetic abnormalities. It remains unknown whether it is a premalignant entity, similar to monoclonal gammopathies of unknown significance. Hence, accurate cytologic diagnosis and follow-up are essential.

Copyright © 2010 Elsevier España, S.L. All rights reserved.

PMID:
21396665
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Loading ...
    Write to the Help Desk