3 research outputs found
Successful Pregnancy and Persistent Polyclonal B Cell Lymphocytosis (PPBL): A Case Study of a Rare Co-Existence
Objective: Unknown etiology
Background: Persistent polyclonal B cell lymphocytosis (PPBL) is a
benign clinical condition, which is characterized by persistent absolute
polyclonal B lymphocytosis (>4.0 K/mu L), with the presence of
circulating binucleated lymphocytes on the peripheral blood smear and an
extra 3 chromosome long arm i(3q) in most cases. Immunophenotype reveals
the polyclonal population of B cell lymphocytes with expression of CD19,
CD20, and CD22 antigens, and k and l immunoglobulin light chains.
Patients are mostly asymptomatic. Although PPBL has a benign clinical
course and does not affect the survival expectancy of most patients,
pregnancy seems to be extremely rare in these patients, as only 1 case
reported so far. Although the real role of immunologic disorders,
possibly PPBL, in recurrent pregnancy losses remains unclear, the rarity
of successful pregnancy in PPBL patients could be attributed to the
possible association of PPBL with infertility or recurrent miscarriages.
Case Report: In the present study we present the second published case
of a woman with a typical PPBL and recurrent pregnancy loss with a
successful pregnancy outcome. Close clinical and laboratory monitoring
in combination with the administration of thromboprophylaxis and the
induction of mild immunosuppression with low-dose prednisolone may have
contributed to the successful outcome of the pregnancy.
Conclusions: In conclusion and taking all these findings into
consideration, pregnancy in patients with PPBL seems to be extremely
rare and the contribution of PPBL to the 2 previous miscarriages in our
case could not be excluded
Central nervous system involvement in primary bone marrow or splenic marginal zone lymphoma: Report of two cases and review of the literature
Other malignancies in the history of CLL: an international multicenter study conducted by ERIC, the European Research Initiative on CLL, in HARMONY
Background: Patients with chronic lymphocytic leukemia (CLL) have a higher risk of developing other malignancies (OMs) compared to the general population. However, the impact of CLL-related risk factors and CLL-directed treatment is still unclear and represents the focus of this work. Methods: We conducted a retrospective international multicenter study to assess the incidence of OMs and detect potential risk factors in 19,705 patients with CLL, small lymphocytic lymphoma, or high-count CLL-like monoclonal B-cell lymphocytosis, diagnosed between 2000 and 2016. Data collection took place between October 2020 and March 2022. Findings: In 129,254 years of follow-up after CLL diagnosis, 3513 OMs were diagnosed (27.2 OMs/1000 person-years). The most common hematological OMs were Richter transformation, myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Non-melanoma skin (NMSC) and prostate cancers were the most common solid tumors (STs). The only predictor for MDS and AML development was treatment with fludarabine and cyclophosphamide with/without rituximab (FC ± R) (OR = 3.7; 95% CI = 2.79–4.91; p < 0.001). STs were more frequent in males and patients with unmutated immunoglobulin heavy variable genes (OR = 1.77; 95% CI = 1.49–2.11; p < 0.001/OR = 1.89; 95% CI = 1.6–2.24; p < 0.001). CLL-directed treatment was associated with non-melanoma skin and prostate cancers (OR = 1.8; 95% CI = 1.36–2.41; p < 0.001/OR = 2.11; 95% CI = 1.12–3.97; p = 0.021). In contrast, breast cancers were more frequent in untreated patients (OR = 0.17; 95% CI = 0.08–0.33; p < 0.001). Patients with CLL and an OM had inferior overall survival (OS) than those without. AML and MDS conferred the worst OS (p < 0.001). Interpretation: OMs in CLL impact on OS. Treatment for CLL increased the risk for AML/MDS, prostate cancer, and NMSC. FCR was associated with increased risk for AML/MDS. Funding: AbbVie, and EU/ EFPIA Innovative Medicines Initiative Joint Undertaking HARMONY grant n° 116026