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MONOCLONAL B-CELL LYMPHOCYTOSIS (MBL) AND PROSTATE CANCER: AN UNEXPECTED, POSSIBLE ASSOCIATION
Author(s): ,
Fiorella D'auria
Affiliations:
IRCCS-CROB, Referral Cancer Center of Basilicata,Rionero in Vulture (PZ),Italy
,
Luciana Rago
Affiliations:
IRCCS-CROB, Referral Cancer Center of Basilicata,Rionero in Vulture (PZ),Italy
,
Luciana Valvano
Affiliations:
IRCCS-CROB, Referral Cancer Center of Basilicata,Rionero in Vulture (PZ),Italy
,
Teodora Statuto
Affiliations:
IRCCS-CROB, Referral Cancer Center of Basilicata,Rionero in Vulture (PZ),Italy
,
Antonio Traficante
Affiliations:
IRCCS-CROB, Referral Cancer Center of Basilicata,Rionero in Vulture (PZ),Italy
,
Vittorio Simeon
Affiliations:
IRCCS-CROB, Referral Cancer Center of Basilicata,Rionero in Vulture (PZ),Italy
,
Vincenzo Fusco
Affiliations:
IRCCS-CROB, Referral Cancer Center of Basilicata,Rionero in Vulture (PZ),Italy
Pellegrino Musto
Affiliations:
IRCCS-CROB, Referral Cancer Center of Basilicata,Rionero in Vulture (PZ),Italy
(Abstract release date: 05/18/17) EHA Library. D'auria F. 05/18/17; 182515; PB1801
Fiorella D'auria
Fiorella D'auria
Contributions
Abstract

Abstract: PB1801

Type: Publication Only

Background
Monoclonal B-cell lymphocytosis (MBL) is a recently recognized entity characterized by the presence, in the peripheral blood, of a monoclonal B-cell population lower than 5000/µl, in the absence of any type of clinical features. MBL clones may have: a) chronic lymphocytic leukemia (CLL-like) phenotype (CD5+, CD19+, CD23+, CD20 dim); b) atypical CLL phenotype (CD5+, CD19+, CD23- or CD20 bright); c) non-CLL phenotype (CD5-). MBL can be also distinguished in “low-count” (<500/µl) and “high-count” (>500/µl) subtypes. High-count MBL frequently shows typical CLL phenotypic/genetic features and require adequate follow-up in order to detect their possible evolution into symptomatic CLL. MBL showing a clonal B-cell count higher than 1000-1500/µl are usually defined “clinical” MBL.

Using highly sensitive (i.e. > 6 colors and > 500000 events) flow cytometry approaches, CLL-like MBL clones have been found at a frequency of 7-12% in healthy subjects, showing, however, very low median counts of clonal B-cell (10-170/µl), with only 0,14% being clinical MBL.
Though several studies have described the association between CLL and various types of neoplastic disorders, only few data exist about the risk of non-hematologic cancer in individuals with MBL; in particular, no association between MBL and prostate cancer (PC) has been so far reported.

Aims
To study prospectively the frequency of CLL-like MBL clones in patients affected by PC compared to healthy males of the same ages, after our previous occasional observation of an apparently increased MBL incidence at baseline in a cohort of patients with PC originally studied to detect lymphocyte abnormalities possibly induced by radiotherapy (RT).

Methods

We enrolled 34 consecutive patients affected by PC (mean age 74 years, range 58-91), naïve for chemotherapy (sixteen previously treated with hormone-therapy). All patients were planned to receive whole-pelvis RT with radical (n. 23) or salvage (n. 11) intent. Fifty-four healthy males (mean age 71 years, range 58-87) represented the control group. Immunophenotypic analysis of peripheral lymphocytes before RT was performed by BD FacsCanto II flow cytometer, using a 5-6 colors approach and the following antibody combinations: CD19 FITC/CD5 PE/CD45 PerCP/CD20 PE-Cy7/CD23 APC; Kappa FITC/Lambda PE/CD19 PerCP-Cy5.5/CD20 PE-Cy7/CD5 APC/CD45 APC-Cy7. For each sample, 100000 events were collected. CD45+ lymphocytes were gated on CD45 vs SSC dot plot, then B cells were isolated by gating on CD19 and CD19+ CD5+ cells were interrogated for intensity of CD20. Finally, CD19+ CD5+ CD20dim selected population was analyzed for light chain clonality and CD23 expression.

Results
Median (range) absolute counts of white blood cells (WBC), total lymphocytes and B-cells, as well as absolute single values of MBL clones are reported in Table 1.

In PC patients we found 3 MBL (8,8%), two of which were “high count/clinical” MBL (5.8%). In contrast, in healthy subject group, only one “low count” MBL (1.8%) was detected, showing a very small clone (8 cells/µl). Such a difference was not statistically significant (p = 0.2).

Conclusion
The preliminary results of our prospective study, performed using a routine, not highly sensitive flow cytometry approach, highlight a possible association between (clinical?) MBL and PC, never described before and probably warranting further investigation in a larger number of patients.

Session topic: 6. Chronic lymphocytic leukemia and related disorders - Clinical

Keyword(s): Prostate, B cell subsets

Abstract: PB1801

Type: Publication Only

Background
Monoclonal B-cell lymphocytosis (MBL) is a recently recognized entity characterized by the presence, in the peripheral blood, of a monoclonal B-cell population lower than 5000/µl, in the absence of any type of clinical features. MBL clones may have: a) chronic lymphocytic leukemia (CLL-like) phenotype (CD5+, CD19+, CD23+, CD20 dim); b) atypical CLL phenotype (CD5+, CD19+, CD23- or CD20 bright); c) non-CLL phenotype (CD5-). MBL can be also distinguished in “low-count” (<500/µl) and “high-count” (>500/µl) subtypes. High-count MBL frequently shows typical CLL phenotypic/genetic features and require adequate follow-up in order to detect their possible evolution into symptomatic CLL. MBL showing a clonal B-cell count higher than 1000-1500/µl are usually defined “clinical” MBL.

Using highly sensitive (i.e. > 6 colors and > 500000 events) flow cytometry approaches, CLL-like MBL clones have been found at a frequency of 7-12% in healthy subjects, showing, however, very low median counts of clonal B-cell (10-170/µl), with only 0,14% being clinical MBL.
Though several studies have described the association between CLL and various types of neoplastic disorders, only few data exist about the risk of non-hematologic cancer in individuals with MBL; in particular, no association between MBL and prostate cancer (PC) has been so far reported.

Aims
To study prospectively the frequency of CLL-like MBL clones in patients affected by PC compared to healthy males of the same ages, after our previous occasional observation of an apparently increased MBL incidence at baseline in a cohort of patients with PC originally studied to detect lymphocyte abnormalities possibly induced by radiotherapy (RT).

Methods

We enrolled 34 consecutive patients affected by PC (mean age 74 years, range 58-91), naïve for chemotherapy (sixteen previously treated with hormone-therapy). All patients were planned to receive whole-pelvis RT with radical (n. 23) or salvage (n. 11) intent. Fifty-four healthy males (mean age 71 years, range 58-87) represented the control group. Immunophenotypic analysis of peripheral lymphocytes before RT was performed by BD FacsCanto II flow cytometer, using a 5-6 colors approach and the following antibody combinations: CD19 FITC/CD5 PE/CD45 PerCP/CD20 PE-Cy7/CD23 APC; Kappa FITC/Lambda PE/CD19 PerCP-Cy5.5/CD20 PE-Cy7/CD5 APC/CD45 APC-Cy7. For each sample, 100000 events were collected. CD45+ lymphocytes were gated on CD45 vs SSC dot plot, then B cells were isolated by gating on CD19 and CD19+ CD5+ cells were interrogated for intensity of CD20. Finally, CD19+ CD5+ CD20dim selected population was analyzed for light chain clonality and CD23 expression.

Results
Median (range) absolute counts of white blood cells (WBC), total lymphocytes and B-cells, as well as absolute single values of MBL clones are reported in Table 1.

In PC patients we found 3 MBL (8,8%), two of which were “high count/clinical” MBL (5.8%). In contrast, in healthy subject group, only one “low count” MBL (1.8%) was detected, showing a very small clone (8 cells/µl). Such a difference was not statistically significant (p = 0.2).

Conclusion
The preliminary results of our prospective study, performed using a routine, not highly sensitive flow cytometry approach, highlight a possible association between (clinical?) MBL and PC, never described before and probably warranting further investigation in a larger number of patients.

Session topic: 6. Chronic lymphocytic leukemia and related disorders - Clinical

Keyword(s): Prostate, B cell subsets

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