Progression and survival of MBL: a screening study of 10 139 individuals

Susan L. Slager; Sameer A. Parikh; Sara J. Achenbach; Aaron D. Norman; Kari G. Rabe; Nicholas J. Boddicker; Janet E. Olson; Geffen Kleinstern; Connie E. Lesnick; Timothy G. Call; James R. Cerhan; Celine M. Vachon; Neil E. Kay; Esteban Braggio; Curtis A. Hanson; Tait D. Shanafelt

doi:10.1182/blood.2022016279

Progression and survival of MBL: a screening study of 10 139 individuals

Susan L. Slager, Sameer A. Parikh, Sara J. Achenbach, Aaron D. Norman, Kari G. Rabe, Nicholas J. Boddicker, Janet E. Olson, Geffen Kleinstern, Connie E. Lesnick, Timothy G. Call, James R. Cerhan, Celine M. Vachon, Neil E. Kay, Esteban Braggio, Curtis A. Hanson, Tait D. Shanafelt

School of Public Health

Research output: Contribution to journal › Article › peer-review

Abstract

Monoclonal B-cell lymphocytosis (MBL) is a common hematological premalignant condition that is understudied in screening cohorts. MBL can be classified into low-count (LC) and high-count (HC) types based on the size of the B-cell clone. Using the Mayo Clinic Biobank, we screened for MBL and evaluated its association with future hematologic malignancy and overall survival (OS). We had a two-stage study design including discovery and validation cohorts. We screened for MBL using an eight-color flow-cytometry assay. Medical records were abstracted for hematological cancers and death. We used Cox regression to evaluate associations and estimate hazard ratios and 95% confidence intervals (CIs), adjusting for age and sex. We identified 1712 (17%) individuals with MBL (95% LC-MBL), and the median follow-up time for OS was 34.4 months with 621 individuals who died. We did not observe an association with OS among individuals with LC-MBL (P = .78) but did among HC-MBL (hazard ratio, 1.8; 95% CI, 1.1-3.1; P = .03). Among the discovery cohort with a median of 10.0 years follow-up, 31 individuals developed hematological cancers with two-thirds being lymphoid malignancies. MBL was associated with 3.6-fold risk of hematological cancer compared to controls (95% CI, 1.7-7.7; P < .001) and 7.7-fold increased risk for lymphoid malignancies (95% CI:3.1-19.2; P < .001). LC-MBL was associated with 4.3-fold risk of lymphoid malignancies (95% CI, 1.4-12.7; P = .009); HC-MBL had a 74-fold increased risk (95% CI, 22-246; P < .001). In this large screening cohort, we observed similar survival among individuals with and without LC-MBL, yet individuals with LC-MBL have a fourfold increased risk of lymphoid malignancies. Accumulating evidence indicates that there are clinical consequences to LC-MBL, a condition that affects 8 to 10 million adults in the United States.

Original language	English
Pages (from-to)	1702-1709
Number of pages	8
Journal	Blood
Volume	140
Issue number	15
DOIs	https://doi.org/10.1182/blood.2022016279
State	Published - 13 Oct 2022

Bibliographical note

Funding Information:
The authors thank the individuals from the Mayo Clinic Biobank for their contributions and continuing participation. This work would not be done without their valuable time and effort. This work was supported by the National Institutes of Health (NIH), National Institute on Aging grant R01 AG58266 and NIH National Cancer Institute grants R01 CA200703, and P50 CA097274. The Mayo Clinic Center for Individualized Medicine provided the Mayo Clinic Biobank materials.

Funding Information:
The authors thank the individuals from the Mayo Clinic Biobank for their contributions and continuing participation. This work would not be done without their valuable time and effort. This work was supported by the National Institutes of Health (NIH), National Institute on Aging grant R01 AG58266 and NIH National Cancer Institute grants R01 CA200703 , and P50 CA097274 . The Mayo Clinic Center for Individualized Medicine provided the Mayo Clinic Biobank materials.

Publisher Copyright:
© 2022 American Society of Hematology

ASJC Scopus subject areas

Biochemistry
Immunology
Hematology
Cell Biology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1182/blood.2022016279

Cite this

Slager, S. L., Parikh, S. A., Achenbach, S. J., Norman, A. D., Rabe, K. G., Boddicker, N. J., Olson, J. E., Kleinstern, G., Lesnick, C. E., Call, T. G., Cerhan, J. R., Vachon, C. M., Kay, N. E., Braggio, E., Hanson, C. A., & Shanafelt, T. D. (2022). Progression and survival of MBL: a screening study of 10 139 individuals. Blood, 140(15), 1702-1709. https://doi.org/10.1182/blood.2022016279

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title = "Progression and survival of MBL: a screening study of 10 139 individuals",

abstract = "Monoclonal B-cell lymphocytosis (MBL) is a common hematological premalignant condition that is understudied in screening cohorts. MBL can be classified into low-count (LC) and high-count (HC) types based on the size of the B-cell clone. Using the Mayo Clinic Biobank, we screened for MBL and evaluated its association with future hematologic malignancy and overall survival (OS). We had a two-stage study design including discovery and validation cohorts. We screened for MBL using an eight-color flow-cytometry assay. Medical records were abstracted for hematological cancers and death. We used Cox regression to evaluate associations and estimate hazard ratios and 95% confidence intervals (CIs), adjusting for age and sex. We identified 1712 (17%) individuals with MBL (95% LC-MBL), and the median follow-up time for OS was 34.4 months with 621 individuals who died. We did not observe an association with OS among individuals with LC-MBL (P = .78) but did among HC-MBL (hazard ratio, 1.8; 95% CI, 1.1-3.1; P = .03). Among the discovery cohort with a median of 10.0 years follow-up, 31 individuals developed hematological cancers with two-thirds being lymphoid malignancies. MBL was associated with 3.6-fold risk of hematological cancer compared to controls (95% CI, 1.7-7.7; P < .001) and 7.7-fold increased risk for lymphoid malignancies (95% CI:3.1-19.2; P < .001). LC-MBL was associated with 4.3-fold risk of lymphoid malignancies (95% CI, 1.4-12.7; P = .009); HC-MBL had a 74-fold increased risk (95% CI, 22-246; P < .001). In this large screening cohort, we observed similar survival among individuals with and without LC-MBL, yet individuals with LC-MBL have a fourfold increased risk of lymphoid malignancies. Accumulating evidence indicates that there are clinical consequences to LC-MBL, a condition that affects 8 to 10 million adults in the United States.",

author = "Slager, {Susan L.} and Parikh, {Sameer A.} and Achenbach, {Sara J.} and Norman, {Aaron D.} and Rabe, {Kari G.} and Boddicker, {Nicholas J.} and Olson, {Janet E.} and Geffen Kleinstern and Lesnick, {Connie E.} and Call, {Timothy G.} and Cerhan, {James R.} and Vachon, {Celine M.} and Kay, {Neil E.} and Esteban Braggio and Hanson, {Curtis A.} and Shanafelt, {Tait D.}",

note = "Funding Information: The authors thank the individuals from the Mayo Clinic Biobank for their contributions and continuing participation. This work would not be done without their valuable time and effort. This work was supported by the National Institutes of Health (NIH), National Institute on Aging grant R01 AG58266 and NIH National Cancer Institute grants R01 CA200703, and P50 CA097274. The Mayo Clinic Center for Individualized Medicine provided the Mayo Clinic Biobank materials. Funding Information: The authors thank the individuals from the Mayo Clinic Biobank for their contributions and continuing participation. This work would not be done without their valuable time and effort. This work was supported by the National Institutes of Health (NIH), National Institute on Aging grant R01 AG58266 and NIH National Cancer Institute grants R01 CA200703 , and P50 CA097274 . The Mayo Clinic Center for Individualized Medicine provided the Mayo Clinic Biobank materials. Publisher Copyright: {\textcopyright} 2022 American Society of Hematology",

year = "2022",

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doi = "10.1182/blood.2022016279",

language = "English",

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T1 - Progression and survival of MBL

T2 - a screening study of 10 139 individuals

AU - Slager, Susan L.

AU - Parikh, Sameer A.

AU - Achenbach, Sara J.

AU - Norman, Aaron D.

AU - Rabe, Kari G.

AU - Boddicker, Nicholas J.

AU - Olson, Janet E.

AU - Kleinstern, Geffen

AU - Lesnick, Connie E.

AU - Call, Timothy G.

AU - Cerhan, James R.

AU - Vachon, Celine M.

AU - Kay, Neil E.

AU - Braggio, Esteban

AU - Hanson, Curtis A.

AU - Shanafelt, Tait D.

N1 - Funding Information: The authors thank the individuals from the Mayo Clinic Biobank for their contributions and continuing participation. This work would not be done without their valuable time and effort. This work was supported by the National Institutes of Health (NIH), National Institute on Aging grant R01 AG58266 and NIH National Cancer Institute grants R01 CA200703, and P50 CA097274. The Mayo Clinic Center for Individualized Medicine provided the Mayo Clinic Biobank materials. Funding Information: The authors thank the individuals from the Mayo Clinic Biobank for their contributions and continuing participation. This work would not be done without their valuable time and effort. This work was supported by the National Institutes of Health (NIH), National Institute on Aging grant R01 AG58266 and NIH National Cancer Institute grants R01 CA200703 , and P50 CA097274 . The Mayo Clinic Center for Individualized Medicine provided the Mayo Clinic Biobank materials. Publisher Copyright: © 2022 American Society of Hematology

PY - 2022/10/13

Y1 - 2022/10/13

N2 - Monoclonal B-cell lymphocytosis (MBL) is a common hematological premalignant condition that is understudied in screening cohorts. MBL can be classified into low-count (LC) and high-count (HC) types based on the size of the B-cell clone. Using the Mayo Clinic Biobank, we screened for MBL and evaluated its association with future hematologic malignancy and overall survival (OS). We had a two-stage study design including discovery and validation cohorts. We screened for MBL using an eight-color flow-cytometry assay. Medical records were abstracted for hematological cancers and death. We used Cox regression to evaluate associations and estimate hazard ratios and 95% confidence intervals (CIs), adjusting for age and sex. We identified 1712 (17%) individuals with MBL (95% LC-MBL), and the median follow-up time for OS was 34.4 months with 621 individuals who died. We did not observe an association with OS among individuals with LC-MBL (P = .78) but did among HC-MBL (hazard ratio, 1.8; 95% CI, 1.1-3.1; P = .03). Among the discovery cohort with a median of 10.0 years follow-up, 31 individuals developed hematological cancers with two-thirds being lymphoid malignancies. MBL was associated with 3.6-fold risk of hematological cancer compared to controls (95% CI, 1.7-7.7; P < .001) and 7.7-fold increased risk for lymphoid malignancies (95% CI:3.1-19.2; P < .001). LC-MBL was associated with 4.3-fold risk of lymphoid malignancies (95% CI, 1.4-12.7; P = .009); HC-MBL had a 74-fold increased risk (95% CI, 22-246; P < .001). In this large screening cohort, we observed similar survival among individuals with and without LC-MBL, yet individuals with LC-MBL have a fourfold increased risk of lymphoid malignancies. Accumulating evidence indicates that there are clinical consequences to LC-MBL, a condition that affects 8 to 10 million adults in the United States.

AB - Monoclonal B-cell lymphocytosis (MBL) is a common hematological premalignant condition that is understudied in screening cohorts. MBL can be classified into low-count (LC) and high-count (HC) types based on the size of the B-cell clone. Using the Mayo Clinic Biobank, we screened for MBL and evaluated its association with future hematologic malignancy and overall survival (OS). We had a two-stage study design including discovery and validation cohorts. We screened for MBL using an eight-color flow-cytometry assay. Medical records were abstracted for hematological cancers and death. We used Cox regression to evaluate associations and estimate hazard ratios and 95% confidence intervals (CIs), adjusting for age and sex. We identified 1712 (17%) individuals with MBL (95% LC-MBL), and the median follow-up time for OS was 34.4 months with 621 individuals who died. We did not observe an association with OS among individuals with LC-MBL (P = .78) but did among HC-MBL (hazard ratio, 1.8; 95% CI, 1.1-3.1; P = .03). Among the discovery cohort with a median of 10.0 years follow-up, 31 individuals developed hematological cancers with two-thirds being lymphoid malignancies. MBL was associated with 3.6-fold risk of hematological cancer compared to controls (95% CI, 1.7-7.7; P < .001) and 7.7-fold increased risk for lymphoid malignancies (95% CI:3.1-19.2; P < .001). LC-MBL was associated with 4.3-fold risk of lymphoid malignancies (95% CI, 1.4-12.7; P = .009); HC-MBL had a 74-fold increased risk (95% CI, 22-246; P < .001). In this large screening cohort, we observed similar survival among individuals with and without LC-MBL, yet individuals with LC-MBL have a fourfold increased risk of lymphoid malignancies. Accumulating evidence indicates that there are clinical consequences to LC-MBL, a condition that affects 8 to 10 million adults in the United States.

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