Abstract
Chronic lymphocytic leukemia (CLL) is well characterized clinically and immunophenotypically. Demonstration of a monotypic CD19+, CD5+ B-cell population is central to the diagnosis. We report 2 cases of biclonal CLL. Two elderly men were encountered with an absolute lymphocytosis consisting of the typical CD5+, CD19+, CD23+ B-cell population seen in CLL; however, immunoglobulin light chain restriction by flow cytometry was not apparent as B cells expressed kappa or lambda light chains without a clear monotypic population. Molecular genetic analysis of flow cytometry-sorted cells (kappa and lambda populations) revealed in both cases 2 monoclonal B-cell populations. The characterization of these cases and a review of the issues surrounding biclonal CLL are presented.
MeSH terms
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Aged
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Antigens, Differentiation, B-Lymphocyte / analysis
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B-Lymphocyte Subsets / metabolism
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B-Lymphocyte Subsets / pathology
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Blotting, Southern
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Clone Cells
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DNA, Neoplasm / analysis
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Flow Cytometry
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Gene Rearrangement, B-Lymphocyte, Heavy Chain
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Humans
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Immunoglobulin Light Chains / analysis
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Immunoglobulin kappa-Chains / metabolism
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Immunoglobulin lambda-Chains / metabolism
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Immunophenotyping
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Karyotyping
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Leukemia, Lymphocytic, Chronic, B-Cell / genetics
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Leukemia, Lymphocytic, Chronic, B-Cell / metabolism
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Leukemia, Lymphocytic, Chronic, B-Cell / pathology*
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Male
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Polymerase Chain Reaction
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Tumor Cells, Cultured
Substances
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Antigens, Differentiation, B-Lymphocyte
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DNA, Neoplasm
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Immunoglobulin Light Chains
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Immunoglobulin kappa-Chains
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Immunoglobulin lambda-Chains