Section of Nephrology, Surgical, Medical and Dental Department of Morphological Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero - Universitaria Policlinico, Modena, Italy.
Section of Hematology, Surgical, Medical and Dental Department of Morphological Sciences, University of Modena and Reggio Emilia, Azienda Ospedaliero - Universitaria Policlinico, Modena, Italy.
Clin Transplant. 2018 Aug;32(8):e13338. doi: 10.1111/ctr.13338. Epub 2018 Aug 26.
Monoclonal B-cell lymphocytosis (MBL) is a lymphoproliferative disorder characterized by clonal expansion of a B-cell population in peripheral blood of otherwise healthy subjects. MBL is divided into CLL (chronic lymphocytic leukemia)-like, atypical CLL-like and non-CLL MBL. The aim of this study was to evaluate immunophenotypic characteristics and clinical outcomes of MBL in kidney transplant (KT) recipients. We retrospectively evaluated 593 kidney transplant (KT) recipients in follow-up at our center. Among them, 157 patients underwent peripheral blood flow cytometry for different clinical indications. A 6-color panel flow cytometry was used to diagnose MBL. This condition was detected in 5 of 157 KT recipients. Immunophenotypic characterization of MBL showed four cases of non-CLL MBL and one case of CLL-like MBL. At presentation, median age was 65 years (range 61-73). After a median follow-up of 3.1 years (95%CI; 1.1-5) from diagnosis, patients did not progress either to CLL or to lymphoma. The disorder did not increase the risk of malignancy, severe infections, graft loss and mortality among our KT recipients. Surprisingly, all cases were also affected by concomitant monoclonal gammopathy of undetermined significance, which did not progress to multiple myeloma during follow-up. In conclusion, our data suggest that MBL is an age-related disorder, with non-CLL MBL being the most common subtype among KT recipients.
单克隆 B 细胞淋巴增生症 (MBL) 是一种以外周血单克隆 B 细胞增殖为特征的淋巴增殖性疾病，患者通常健康。MBL 分为 CLL（慢性淋巴细胞白血病）样、非典型 CLL 样和非 CLL MBL。本研究旨在评估肾移植 (KT) 受者 MBL 的免疫表型特征和临床结局。我们回顾性评估了在本中心接受随访的 593 名肾移植 (KT) 受者。其中，157 名患者因不同的临床指征接受了外周血流式细胞术检查。采用 6 色流式细胞术 panel 诊断 MBL。在 157 例 KT 受者中，有 5 例发现 MBL。MBL 的免疫表型特征显示，4 例为非 CLL MBL，1 例为 CLL 样 MBL。发病时，中位年龄为 65 岁（范围 61-73）。从诊断到中位随访 3.1 年（95%CI；1.1-5）后，患者既未进展为 CLL，也未进展为淋巴瘤。该疾病并未增加 KT 受者发生恶性肿瘤、严重感染、移植物丢失和死亡的风险。令人惊讶的是，所有病例同时还伴有意义未明的单克隆丙种球蛋白血症，在随访期间并未进展为多发性骨髓瘤。总之，我们的数据表明 MBL 是一种与年龄相关的疾病，在 KT 受者中最常见的亚型是非 CLL MBL。
