Chronic lymphocytic leukemia/small lymphocytic lymphoma associated with IgM paraprotein

We studied the clinicopathologic, immunophenotypic, and cytogenetic features of 26 patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) associated with serum IgM paraprotein. The study group (16 men; 10 women; median age, 64 years; range, 40-82 years) represents approximat...

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Bibliographic Details
Published in:American journal of clinical pathology 2005-04, Vol.123 (4), p.594-602
Main Authors: Yin, C Cameron, Lin, Pei, Carney, Dennis A, Handy, Beverly C, Rassidakis, George Z, Admirand, Joan H, Keating, Michael J, Medeiros, L Jeffrey
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Blood Protein Electrophoresis
Bone Marrow - pathology
Chromosome Aberrations
Female
Flow Cytometry
Humans
Immunoglobulin M - blood
Immunoglobulin M - immunology
Immunohistochemistry
Immunophenotyping
Leukemia, Lymphocytic, Chronic, B-Cell - genetics
Leukemia, Lymphocytic, Chronic, B-Cell - immunology
Leukemia, Lymphocytic, Chronic, B-Cell - pathology
Male
Middle Aged
Paraproteins - immunology
Protein-Tyrosine Kinases - metabolism
ZAP-70 Protein-Tyrosine Kinase
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Summary:We studied the clinicopathologic, immunophenotypic, and cytogenetic features of 26 patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) associated with serum IgM paraprotein. The study group (16 men; 10 women; median age, 64 years; range, 40-82 years) represents approximately 2.5% of CLL/SLL cases at our institution. The paraprotein level ranged from 1 to 14 g/L (median, 4 g/L). Neoplasms in bone marrow were composed of small round lymphocytes arranged in nodular (n = 6), diffuse (n = 5), interstitial (n = 5), or mixed (n = 10) patterns. All cases were positive for monotypic surface immunoglobulin light chain, IgM/IgD, CD5, CD19, CD20, and CD23. CD11c (14/20 [70%]), CD79b (11/19 [58%]), FMC-7 (11/26 [42%]), CD22 (8/20 [40%]), and ZAP-70 (6/19 [32%]) were expressed in subsets of cases. Of 17 bone marrow specimens assessed by conventional cytogenetics, 6 were abnormal and 11 were diploid. The overall survival of this group (median follow-up, 24 months) was not significantly different from that for an age-, sex-and stage-matched group of 52 CLL/SLL patients without IgM paraprotein (P = .60). We conclude that CLL/SLL cases with serum IgM paraprotein are similar to other CLL/SLL cases in their clinicopathologic and immunophenotypic features.
ISSN:0002-9173