Predicting clinical outcome in individuals with small CLL B cell clones

? DESCRIPTION (provided by applicant): Our proposal addresses the important issue of predicting in a more accurate and patient specific manner the clinical course for early stage CLL and MBL. CLL-Chronic lymphocytic leukemia (CLL) is one of the most common lymphoid malignancies, accounting for ~11% of all hematologic neoplasms. CLL remains an incurable and devastating malignancy. In addition to having a life expectancy that is substantially shorter than that of age-matched individuals in the general population, individuals living with CLL must also deal with an increased risk of infections, second cancers, and autoimmune complications that can have profound consequences for their quality of life. However there is extreme heterogeneity in the clinical course of CLL patients best illustrated by the fact that 70% of all CLL patients will ultimately require therapy. This latter outcome is complicated since most newly diagnosed CLL patients present to their physician with very early stage disease. While there have been remarkable advances in our understanding of progression events in CLL, our ability to accurately predict which early stage patient will progress to need for therapy is still crude. MBL-Individuals with high count MBL have a circulating clonal B-cell population, an absolute B-cell count