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Survival of patients with clinically identified monoclonal B-cell lymphocytosis (MBL) relative to the age- and sex-matched general population

Leukemia volume 26, pages 373–376 (2012)Cite this article

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Studies conducted over the last 10 years suggest that 3–5% of the general population over age 40 harbor a clonal population of lymphocytes of chronic lymphocytic leukemia (CLL) phenotype when evaluated using sensitive flow cytometry assays.1 This discovery led to creation of the new diagnostic entity monoclonal B-cell lymphocytosis (MBL),2 which is considered the precursor state to CLL and other sub-types of low grade non-Hodgkin's lymphoma.3 The B-cell clone of the majority of individuals with MBL has the same immunophenotype as CLL (CLL-like MBL). Although some data suggest higher B-cell thresholds may better stratify patient outcome,4, 5 the current diagnostic criteria for CLL-like MBL specify patients have a clonal B-cell population of appropriate immunophenotype, an absolute B-cell count <5 × 109/l, and no other characteristics of a lymphoproliferative disorder (for example, lymphadenopathy, organomegaly and B symptoms).2 Individuals with a clone of CLL phenotype who have a B-cell count ⩾5 × 109/l and/or lymphadenopathy are classified as having CLL.6

The natural history of MBL appears to differ based on the absolute B-cell count.4, 7, 8 From an epidemiological perspective, the majority of individuals with MBL have very small clonal lymphocyte populations, a B-cell count within the normal range, and appear to be at low likelihood of developing CLL.9 Such individuals with ‘low count’ MBL do not appear to be at increased risk of death relative to the general population.9

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Authors and Affiliations

  1. Department of Hematology, Mayo Clinic, Rochester, MN, USA

    T D Shanafelt, N E Kay, T G Call, C S Zent & S M Schwager

  2. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

    K G Rabe & S L Slager

  3. Department of Hematology and Oncology, Mayo Clinic, Scottsdale, AZ, USA

    J F Leis

  4. Department of Immunology, Mayo Clinic, Rochester, MN, USA

    D F Jelinek

  5. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA

    C A Hanson

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  1. T D Shanafelt
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Correspondence to T D Shanafelt.

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Shanafelt, T., Kay, N., Rabe, K. et al. Survival of patients with clinically identified monoclonal B-cell lymphocytosis (MBL) relative to the age- and sex-matched general population. Leukemia 26, 373–376 (2012). https://doi.org/10.1038/leu.2011.211

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