Cases of B-CLL with CD8+ B cells are not common (as shown by mostly single case reports published). We have seen only 2 cases; one seems to have had a sensitivity to treatment with fludarabine (Arch Pathol Lab Med, in press). There are, to my knowledge, no more than 2 dozen cases reported and there does not seem to be virtually anything particular to these patients. A poor prognosis claimed in one paper was not confirmed. Mulligan et al (Br J Haematol 1998, 103:157-162) reported the largest series (10 patients) and suggested that this finding (B-CLL with CD8+ cells) might be more common than it seems. Most of the cases showed lambda light chains as sIg and also had CD25 on their abnormal B cells. I am interested in the treatment and clinical response of your patient as well as any other information that you might provide. It would be interesting to check for the rearrengement of both heavy chain and TCR genes. Also, some researchers investigated the composition of CD8. More information as well as a table of the literature review could be obtained by reqest. Regards, Adrain Vladutiu
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