Leukemic Involvement Is a Common Feature in Waldenström Macroglobulinemia at Diagnosis
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients and Samples
2.2. Morphologic, Immunophenotypic, and Molecular Studies
2.3. Statistical Analysis
3. Results
3.1. Patients Characteristics
3.2. Phenotypic Characteristics of Circulating WM Cells
3.3. Morphologic Features in WM with PB Involvement
3.4. Molecular Data in Patients with and without Leukemic Expression by MFC
3.5. Correlation between Leukemic Expression, Clinical and Analytical Data, and Bone Marrow Features
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All Patients N = 100 | Patients with PB Involvement by MFC N = 50 (50%) | Patients without PB Involvement by MFC N = 50 (50%) | Significance (p) | |
---|---|---|---|---|
Median age, years (range, IQR) | 73 (36–97) (IQR: 12.75) | 73 (54–89) (IQR: 14) | 73.5 (36–97) (IQR: 12.5) | p = 0.303 2 |
Sex female/male | 69.5% | 78.6% | 61.3% | p = 0.685 1 |
ECOG > 1 | 3% | 2% | 4% | p = 1.000 1 |
Lymphadenopathy (by physical examination and/or CT scan) | 8% | 8% | 8% | p = 1.000 1 |
Splenomegaly (by physical examination and/or CT scan) | 1% | 0% | 2% | p = 1.000 1 |
Leukocytes (×109/L), median (range, IQR) | 7.08 (3.37–17.58) (IQR: 3.10) | 7.29 (3.97–17.58) (IQR: 3.08) | 6.93 (3.37–17.53) (IQR: 3.63) | p = 0.135 2 |
Lymphocytes (×109/L), median (range, IQR) | 2.00 (0.61–8.81) (IQR: 0.97) | 2.3 (0.77–7.28) (IQR: 1.09) | 1.87 (0.61–8.81) (IQR: 0.89) | p = 0.110 2 |
Lymphocytes ≥ 4 × 109/L | 6% | 8% | 4% | p = 0.678 1 |
Hemoglobin (g/L), median (range, IQR) | 133 (82–178) (IQR: 23.75) | 135 (82–167) (IQR: 20.00) | 131 (88–178) (IQR: 26.25) | p = 0.701 2 |
Platelets (×109/L), median (range, IQR) | 247 (110–669) (IQR: 104.75) | 254 (110–503) (IQR: 109.00) | 243 (124–669) (IQR: 101.25) | p = 0.849 2 |
Increased serum LDH levels | 5% | 2% | 8% | p = 0.362 1 |
Increased serum β2-microglobulin levels | 40.8% | 50% | 32% | p = 0.100 1 |
Serum monoclonal component (g/L), median (range, IQR) | 12.72 (1.89–72.80) (IQR: 6.36) | 12.36 (5.93–43.50) (IQR: 5.38) | 13.63 (1.89–72.80) (IQR: 7.30) | p = 0.397 2 |
Serum monoclonal component ≥ 15 g/L | 33% | 26% | 40% | p = 0.202 1 |
Serum monoclonal component ≥ 30 g/L | 5% | 6% | 4% | p = 1.000 1 |
Positive urine immunofixation | 25% | 30.3% | 19.3% | p = 0.550 1 |
PB involvement by MFC | 50% | - | - | - |
Median % CD19 from total lymphocytes in PB (range, IQR) | 6.00 (0.6–47) (IQR: 6.75) | 7.5 (0.6–47) (IQR: 11.10) | 5.00 (0.7–32) (IQR: 4.70) | p = 0.001 2 |
Median % clonal CD19 from total CD19 in PB (range, IQR) | - | 60 (8–99) (IQR: 60) | - | - |
CD5 expression in PB in leukemic cases | - | 24% | - | - |
Median % CD19 from total lymphocytes in BM (range, IQR) | 34 (4–76) (IQR: 25) | 35 (5–76) (IQR: 22) | 23,50 (4–60) (IQR: 23) | p = 0.006 2 |
Median % clonal CD19 from total CD19 in BM (range, IQR) | 80 (0–100) (IQR: 45) | 90 (6–100) (IQR: 34) | 70 (0–100) (IQR: 52) | p = 0.046 2 |
BM lymphocytes, % (range) | 22 (8–91) | 28 (8–91) | 18 (10–47) | p = 0.008 2 |
BM plasma cells, % (range) | 4 (0–18) | 3 (1–15) | 4 (0–18) | p = 0.811 2 |
Treatment at presentation | 13% | 14% | 12% | p = 1.000 1 |
PB Involvement by MFC Detected 50/100 (50%) | PB Involvement by MFC Not Detected 50/100 (50%) | ||
---|---|---|---|
MYD88 L265P mutation by AS-qPCR in PB | MYD88mut | 50/50 (100%) | 15/50 (30%) |
MYD88wt | 0/50 (0%) | 35/50 (70%) | |
IGH gene rearrangement in PB | IGH rearranged | 44/49 * (90%) | 20 **/50 (40%) |
IGH non rearranged | 5/49 * (10%) | 30/50 (60%) |
FITC | PE | PerCPCy5.5 | PECy7 | APC | APC-H7 | V-450 | V-500 |
---|---|---|---|---|---|---|---|
CD22 | CD25 | CD11c | CD19 | Kappa | Lambda | CD20 | CD45 |
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Montesdeoca, S.; García-Gisbert, N.; Calvo, X.; Arenillas, L.; Román, D.; Fernández-Rodríguez, C.; Navarro, R.; Costan, B.; Vela, M.d.C.; Camacho, L.; et al. Leukemic Involvement Is a Common Feature in Waldenström Macroglobulinemia at Diagnosis. Cancers 2023, 15, 4152. https://doi.org/10.3390/cancers15164152
Montesdeoca S, García-Gisbert N, Calvo X, Arenillas L, Román D, Fernández-Rodríguez C, Navarro R, Costan B, Vela MdC, Camacho L, et al. Leukemic Involvement Is a Common Feature in Waldenström Macroglobulinemia at Diagnosis. Cancers. 2023; 15(16):4152. https://doi.org/10.3390/cancers15164152
Chicago/Turabian StyleMontesdeoca, Sara, Nieves García-Gisbert, Xavier Calvo, Leonor Arenillas, David Román, Concepción Fernández-Rodríguez, Rosa Navarro, Beatriz Costan, María del Carmen Vela, Laura Camacho, and et al. 2023. "Leukemic Involvement Is a Common Feature in Waldenström Macroglobulinemia at Diagnosis" Cancers 15, no. 16: 4152. https://doi.org/10.3390/cancers15164152
APA StyleMontesdeoca, S., García-Gisbert, N., Calvo, X., Arenillas, L., Román, D., Fernández-Rodríguez, C., Navarro, R., Costan, B., Vela, M. d. C., Camacho, L., Abella, E., Colomo, L., Salido, M., Puiggros, A., Florensa, L., Espinet, B., Bellosillo, B., & Ferrer del Álamo, A. (2023). Leukemic Involvement Is a Common Feature in Waldenström Macroglobulinemia at Diagnosis. Cancers, 15(16), 4152. https://doi.org/10.3390/cancers15164152