Monoclonal B-cells lymphocytosis (MBL) is a benign condition that may precede chronic lymphocytic leukemia (CLL), not rarely present in peripheral blood of healthy elderly people, among which there is also a male prevalence. Though CLL has been associated with various types of solid tumors, including prostate cancer (PC), no data exist about the relationship between PC and MBL. We studied the frequency of CLL-like MBL clones in a group of 48 patients affected by PC and followed them during and after whole-pelvis radiotherapy (WPRT) treatment. We found four MBL clones (8.3%), two of which (4.2%) had a B-cell clonal count >1000 cells/µL (‘clinical MBL’). A single case (1.8%) of ‘low-count’ MBL occurred in a control group of 54 healthy males. Notably, normal B-lymphocytes were consistently affected by WPRT, while MBL clones were less radiosensitive. Our results suggest a possible association between ‘clinical’ MBL and PC and show a different impact of the radiation on monoclonal respect to normal B-cells, which could also imply a greater risk of clonal transformation.
RawstronAC, ShanafeltT, LanasaMC, . Different biology and clinical outcome according to the absolute numbers of clonal B-cells in monoclonal B-cell lymphocytosis (MBL). Cytometry B Clin Cytom2010;78(suppl 1):S19–S23.doi:10.1002/cyto.b.20533
3.
GhiaP. Another piece of the puzzle: is there a “nodal” monoclonal B-cell lymphocytosis?Haematologica2011;96:1089–91.doi:10.3324/haematol.2011.047712
4.
ShimYK, RachelJM, GhiaP, . Monoclonal B-cell lymphocytosis in healthy blood donors: an unexpectedly common finding. Blood2014;123:1319–26.doi:10.1182/blood-2013-08-523704
5.
NietoWG, AlmeidaJ, RomeroA, . Increased frequency (12%) of circulating chronic lymphocytic leukemia-like B-cell clones in healthy subjects using a highly sensitive multicolor flow cytometry approach. Blood2009;114:33–7.doi:10.1182/blood-2009-01-197368
DasanuCA, AlexandrescuDT. Risk for second nonlymphoid neoplasms in chronic lymphocytic leukemia. MedGenMed2007;9:35.
8.
TsimberidouAM, WenS, McLaughlinP, . Other malignancies in chronic lymphocytic leukemia/small lymphocytic lymphoma. J Clin Oncol2009;27:904–10.doi:10.1200/JCO.2008.17.5398
9.
SolomonBM, ChaffeeKG, MoreiraJ, . Risk of non-hematologic cancer in individuals with high-count monoclonal B-cell lymphocytosis. Leukemia2016;30:331–6.doi:10.1038/leu.2015.235
10.
D'AuriaF, RagoL, ValvanoL, . Monoclonal B-cell lymphocytosis and prostate cancer: an unexpected, possible association. Haematologica2017;102(s2):PB1801.
11.
RoyleJA, BaadePD, JoskeD, . Second cancer incidence and cancer mortality among chronic lymphocytic leukaemia patients: a population-based study. Br J Cancer2011;105:1076–81.doi:10.1038/bjc.2011.313
12.
FalchiL, VitaleC, KeatingMJ, . Incidence and prognostic impact of other cancers in a population of long-term survivors of chronic lymphocytic leukemia. Ann Oncol2016;27:1100–6.doi:10.1093/annonc/mdw072
13.
van den BroekEC, LiuL, PosthumaEF, . Increased risk of chronic lymphocytic leukaemia among cancer survivors in the Netherlands: increased detection, causal factors or both?Ann Hematol2014;93:157–62.doi:10.1007/s00277-013-1929-4
14.
BallarioR, BeltramiP, CavalleriS, . An unusual pathological finding of chronic lymphocitic leukemia and adenocarcinoma of the prostate after transurethral resection for complete urinary retention: case report. BMC Cancer2004;4:95.doi:10.1186/1471-2407-4-95
15.
GajendraS, SharmaR, SahooMK. Triple cancer: chronic lymphocytic leukemia with bladder and prostate carcinoma. Malays J Pathol2015;37:159–63.
16.
MoleroT, LemesA, de la IglesiaS, . Acute promyelocytic leukemia developing after radiotherapy for prostate cancer in a patient with chronic lymphocytic leukemia. Cancer Genet Cytogenet2001;131:141–3.doi:10.1016/S0165-4608(01)00503-9
17.
LouagieH, Van EijkerenM, PhilippeJ, . Changes in peripheral blood lymphocyte subsets in patients undergoing radiotherapy. Int J Radiat Biol1999;75:767–71.doi:10.1080/095530099140113
18.
BelkaC, OttingerH, KreuzfelderE, . Impact of localized radiotherapy on blood immune cells counts and function in humans. Radiother Oncol1999;50:199–204.doi:10.1016/S0167-8140(98)00130-3
19.
SageEK, SchmidTE, SedelmayrM, . Comparative analysis of the effects of radiotherapy versus radiotherapy after adjuvant chemotherapy on the composition of lymphocyte subpopulations in breast cancer patients. Radiother Oncol2016;118:176–80.doi:10.1016/j.radonc.2015.11.016
20.
MellLK, KochanskiJD, RoeskeJC, . Dosimetric predictors of acute hematologic toxicity in cervical cancer patients treated with concurrent cisplatin and intensity-modulated pelvic radiotherapy. Int J Radiat Oncol Biol Phys2006;66:1356–65.doi:10.1016/j.ijrobp.2006.03.018
21.
YangTJ, OhJH, ApteA, . Clinical and dosimetric predictors of acute hematologic toxicity in rectal cancer patients undergoing chemoradiotherapy. Radiother Oncol2014;113:29–34.doi:10.1016/j.radonc.2014.09.002
22.
AlbuquerqueK, GiangrecoD, MorrisonC, . Radiation-related predictors of hematologic toxicity after concurrent chemoradiation for cervical cancer and implications for bone marrow-sparing pelvic IMRT. Int J Radiat Oncol Biol Phys2011;79:1043–7.doi:10.1016/j.ijrobp.2009.12.025
23.
SiniC, FiorinoC, PernaL, . Dose-volume effects for pelvic bone marrow in predicting hematological toxicity in prostate cancer radiotherapy with pelvic node irradiation. Radiother Oncol2016;118:79–84.doi:10.1016/j.radonc.2015.11.020
24.
PinkawaM, DjukicV, KlotzJ, . Hematologic changes during prostate cancer radiation therapy are dependent on the treatment volume. Future Oncol2014;10:835–43.doi:10.2217/fon.13.237
25.
BlomgrenH, EdsmyrF, EspostiPL, . Spontaneous cytotoxicity of blood lymphocytes following local radiation therapy for carcinoma of the urinary bladder. Acta Radiol Oncol1983;22:145–50.doi:10.3109/02841868309134354
26.
YuanC, WangQ. Comparative analysis of the effect of different radiotherapy regimes on lymphocyte and its subpopulations in breast cancer patients. Clin Transl Oncol2018;20:1219–25.doi:10.1007/s12094-018-1851-2
