Abstract
Monoclonal gammopathies are frequently seen in B-cell malignancies. Monoclonal proteins are seen in a significant proportion of patients with chronic lymphocytic leukemia (CLL), which is a clonal disorder of mature B cells. The use of more sensitive laboratory methods has enabled the detection of monoclonal proteins or light chains in the serum and/or urine in the majority of these patients. The presence of some of these monoclonal proteins may explain the different autoimmune phenomena that are associated with this disease. Some reports indicate that the finding of monoclonal proteins has a negative impact on patients’ survival. The presence of two different monoclonal proteins (i.e. biclonal gammopathy) is on the other hand rare. Most of the reported cases in the literature are of patients with plasma cell disorders. In this report, we describe a rare occurrence of biclonal gammopathy in a patient with CLL. Serum protein electrophoresis and immunofixation, which were negative at the time of initial diagnosis, showed biclonal immunoglobin A (IgA) kappa and IgA lambda during the course of the disease. The patient’s disease showed steady progression, despite multiple treatments. Although this could just be the result of using more sensitive laboratory techniques, biclonal gammopathy in this patient likely reflects the evolution of another clone, which would explain the encountered resistance to therapy. Because of paucity of reports, the impact of biclonal gammopathies in such patients is not known and an effort to collectively report the presentation and outcome of these patients is needed to further understand the pathophysiology and clinical significance of such a finding.
| Original language | English |
|---|---|
| Pages (from-to) | 217-218 |
| Number of pages | 2 |
| Journal | Oman Medical Journal |
| Volume | 30 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2015 |
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Keywords
- B-Cell
- Chronic Lymphocytic
- Leukemia
- Leukemia
- Paraproteinemias
ASJC Scopus subject areas
- Medicine(all)
Cite this
Biclonal gammopathy in chronic lymphocytic leukemia : Case report and review of the literature. / Al-Riyami, Nafila; Al-Farsi, Khalil; Al-Amrani, Khalfan; Al-Harrasi, Sameera; Al-Huneini, Mohammed; Al-Kindi, Salam.
In: Oman Medical Journal, Vol. 30, No. 3, 2015, p. 217-218.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Biclonal gammopathy in chronic lymphocytic leukemia
T2 - Case report and review of the literature
AU - Al-Riyami, Nafila
AU - Al-Farsi, Khalil
AU - Al-Amrani, Khalfan
AU - Al-Harrasi, Sameera
AU - Al-Huneini, Mohammed
AU - Al-Kindi, Salam
PY - 2015
Y1 - 2015
N2 - Monoclonal gammopathies are frequently seen in B-cell malignancies. Monoclonal proteins are seen in a significant proportion of patients with chronic lymphocytic leukemia (CLL), which is a clonal disorder of mature B cells. The use of more sensitive laboratory methods has enabled the detection of monoclonal proteins or light chains in the serum and/or urine in the majority of these patients. The presence of some of these monoclonal proteins may explain the different autoimmune phenomena that are associated with this disease. Some reports indicate that the finding of monoclonal proteins has a negative impact on patients’ survival. The presence of two different monoclonal proteins (i.e. biclonal gammopathy) is on the other hand rare. Most of the reported cases in the literature are of patients with plasma cell disorders. In this report, we describe a rare occurrence of biclonal gammopathy in a patient with CLL. Serum protein electrophoresis and immunofixation, which were negative at the time of initial diagnosis, showed biclonal immunoglobin A (IgA) kappa and IgA lambda during the course of the disease. The patient’s disease showed steady progression, despite multiple treatments. Although this could just be the result of using more sensitive laboratory techniques, biclonal gammopathy in this patient likely reflects the evolution of another clone, which would explain the encountered resistance to therapy. Because of paucity of reports, the impact of biclonal gammopathies in such patients is not known and an effort to collectively report the presentation and outcome of these patients is needed to further understand the pathophysiology and clinical significance of such a finding.
AB - Monoclonal gammopathies are frequently seen in B-cell malignancies. Monoclonal proteins are seen in a significant proportion of patients with chronic lymphocytic leukemia (CLL), which is a clonal disorder of mature B cells. The use of more sensitive laboratory methods has enabled the detection of monoclonal proteins or light chains in the serum and/or urine in the majority of these patients. The presence of some of these monoclonal proteins may explain the different autoimmune phenomena that are associated with this disease. Some reports indicate that the finding of monoclonal proteins has a negative impact on patients’ survival. The presence of two different monoclonal proteins (i.e. biclonal gammopathy) is on the other hand rare. Most of the reported cases in the literature are of patients with plasma cell disorders. In this report, we describe a rare occurrence of biclonal gammopathy in a patient with CLL. Serum protein electrophoresis and immunofixation, which were negative at the time of initial diagnosis, showed biclonal immunoglobin A (IgA) kappa and IgA lambda during the course of the disease. The patient’s disease showed steady progression, despite multiple treatments. Although this could just be the result of using more sensitive laboratory techniques, biclonal gammopathy in this patient likely reflects the evolution of another clone, which would explain the encountered resistance to therapy. Because of paucity of reports, the impact of biclonal gammopathies in such patients is not known and an effort to collectively report the presentation and outcome of these patients is needed to further understand the pathophysiology and clinical significance of such a finding.
KW - B-Cell
KW - Chronic Lymphocytic
KW - Leukemia
KW - Leukemia
KW - Paraproteinemias
UR - http://www.scopus.com/inward/record.url?scp=84935028409&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84935028409&partnerID=8YFLogxK
U2 - 10.5001/omj.2015.45
DO - 10.5001/omj.2015.45
M3 - Article
AN - SCOPUS:84935028409
VL - 30
SP - 217
EP - 218
JO - Oman Medical Journal
JF - Oman Medical Journal
SN - 1999-768X
IS - 3
ER -