Clonal lymphocytic populations in Philadelphia-negative chronic myeloproliferative disorders: is the T-cell clonality of 'undetermined' significance (TCUS) linked to a worse clinical outcome?

Leuk Lymphoma. 2006 Nov;47(11):2351-8. doi: 10.1080/10428190600834487.

Abstract

This study examined the clonality of B- and T-cells by PCR in 83 patients with Philadelphia-negative myeloproliferative disorders (Ph-MPD), to investigate its clinical and morphological correlates. Clonal lymphocytic populations were found in 23% of patients (T: n = 20, B: n = 3), with no frequency differences between ET, CIMF and PV. At the presentation, patients with clonal bands were older (58.1+/-13.8 vs 47.5+/-14.6, p = 0.0039), but did not differ in other clinical parameters. After the median follow-up of 21 months they were less likely to be asymptomatic (11.8% vs 41.1%, p = 0.029). The T-cell clonality was the strongest predictor of the symptomatic last follow-up by discriminant function analysis, surpassing the patient's age. This surprising negative prognostic impact of lymphocyte clonality in Ph-MPD may result from this phenomenon to be a better measure of the 'hematopoietic biologic age' than the metrical age itself.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biopsy
  • Bone Marrow / pathology
  • Chronic Disease
  • Clone Cells / pathology*
  • Humans
  • Immunoglobulins / genetics
  • Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / classification
  • Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / epidemiology
  • Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / pathology*
  • Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative / therapy*
  • Middle Aged
  • Myeloproliferative Disorders / classification
  • Myeloproliferative Disorders / epidemiology
  • Myeloproliferative Disorders / pathology*
  • Myeloproliferative Disorders / therapy*
  • Receptors, Antigen, T-Cell, gamma-delta / genetics
  • T-Lymphocytes / classification
  • T-Lymphocytes / pathology*
  • Treatment Outcome

Substances

  • Immunoglobulins
  • Receptors, Antigen, T-Cell, gamma-delta