Prevalence and Immunophenotypic Characteristics of Monoclonal B-Cell Lymphocytosis in Healthy Korean Individuals With Lymphocytosis
ANNALS OF LABORATORY MEDICINE
Authors: Yoo, In Young; Bang, Sung Hoan; Lim, Dae Jin; Kim, Seok Jin; Kim, Kyunga; Kim, Hee Jin; Kim, Sun-Hee; Cho, Duck
Abstract
Epidemiological studies of monoclonal B-cell lymphocytosis (MBL) have been conducted in limited geographical regions. Little is known about the prevalence of MBL in Asia. We investigated the prevalence and immunophenotypic characteristics of MBL in Koreans who had idiopathic lymphocytosis (lymphocyte count >4.0x 10(9)/L) and were >= 40 years of age. A total of 105 leftover peripheral blood samples met these criteria among those from 73,727 healthy individuals who visited the Health Promotion Center, Samsung Medical Center, Korea, from June 2018 to August 2019. The samples were analyzed using eight-color flow cytometry with the following monoclonal antibodies: CD45, CD5, CD10, CD19, CD20, CD23, and kappa and lambda light chains. The overall prevalence of MBL in the study population was 2.9% (3/105); there was one case of chronic lymphocytic leukemia (CLL)-like MBL (CD5(+)CD23(-)), one case of atypical CLL-like MBL (CD5(+)CD23(-)), and one case of CD5(-) MBL with a lambda restriction pattern. This is the first study on the MBL prevalence in an East Asian population, and it reveals a relatively low prevalence of MBL in healthy Korean individuals with lymphocytosis.
The clinical significance of CD49e and CD56 for multiple myeloma in the novel agents era
MEDICAL ONCOLOGY
Authors: Okura, Miyuki; Ida, Naoko; Yamauchi, Takahiro
Abstract
Multiple myeloma (MM) is a hematological malignancy characterized by the proliferation of abnormal plasma cells in bone marrow. Flow cytometry distinguishes between normal and abnormal plasma cells by evaluating cluster of differentiation (CD) 56 and CD19 expression patterns. Moreover, immunophenotyping of mature plasma cell 1 (MPC-1) and very late antigen-5 (CD49e) identifies the maturity of MM as mature (MPC-1(+), CD49e(+)), intermediate (MPC-1(+), CD49e(-)), or immature (MPC-1(-), CD49e(-)). We retrospectively examined the effects of surface marker expression and maturity subtype on overall survival (OS) and time to next treatment (TNT) among 55 patients (25 males, 30 females) with symptomatic MM. All patients were treated with regimens containing bortezomib (BOR) (n = 39) or lenalidomide (LEN) (n = 16) as the initial treatment. Median age at diagnosis was 72 years (range: 36-88). The lack of CD56, an aberrant marker, was associated with significantly worse prognosis compared with CD56(+)MM (median OS: 24 vs. 60 months, respectively;p = 0.0050). In CD49e(+)MM, defined as mature type, no significant difference was seen in TNT of the initial treatment, regardless of whether it was a BOR-based regimen or LEN + dexamethasone (Ld) therapy. On the other hand, in CD49e(-)MM, defined as immature/intermediate type, TNT of Ld therapy was significantly longer than that of BOR-based regimens (median TNT: undefined vs. 12 months, respectively;p = 0.0043). These results suggest that Ld therapy is more effective than BOR-based therapy for CD49e(-)MM and thus may aid regimen-related decisions in the novel agents era.