B-cell count and survival: differentiating chronic lymphocytic leukemia from monoclonal B-cell lymphocytosis based on clinical outcome

摘要: The diagnosis of chronic lymphocytic leukemia (CLL) in asymptomatic patients has historically been based on documenting a characteristic lymphocyte clone and the presence lymphocytosis. There are minimal data regarding which parameter (absolute count [ALC] or B-cell count) what threshold should be used for diagnosis. We analyzed relationship ALC with clinical outcome 459 clonal population CLL phenotype to determine (1) whether count, (2) diagnosis, (3) any independent prognostic value after accounting biologic/molecular markers. had similar predicting treatment-free survival (TFS) overall as continuous variables, but binary factors, 11 × 109/L best predicted survival. remained an predictor TFS controlling ZAP-70, IGHV, CD38, fluorescence situ hybridization (FISH) results (all P < .001). These analyses support basing retaining size diagnostic criteria. Using clinically relevant criteria distinguish between monoclonal lymphocytosis (MBL) could minimize patient distress caused by labeling people at low risk adverse consequences having CLL.