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Persistent polyclonal B-cell lymphocytosis in chronic smokers: more than meets the eye.
MedLine Citation:
PMID:  22670354     Owner:  NLM     Status:  In-Process    
BACKGROUND: Persistent neutrophiliais awell-recognized phenomenon in some chronic cigarette smokers. In contrast, persistent polyclonal B-cell lymphocytosis (PPBL) is considered a rare entity affecting this patient population.
METHODS: We analyzed a cohort of 21 patients with chronic smoking histories presenting with persistent leukocytosis. None of the patients was on steroids, lithium preparations, or other medications known to increase the white blood cell (WBC) counts. We excluded any myeloproliferative or lymphoproliferative conditions in our patient cohort. WBC differential was obtained during repeated visits and the mean values calculated. The results were subsequently compared to known upper normal limits and tested for statistical significance.
RESULTS: The absolute leukocyte count in our cohort was 17.8 +/- 3.2 x 10(9)/L and the absolute neutrophil count was 12.0 +/- 2.8 x 10(9)/L. The difference proved statistically significant for both values when compared to upper normal limits (P < 0.001). Six patients (five females and one male) were also found to have a significant and persistent lymphocytosis at 5.1 +/- 0.5 x 10(9)/L (P < 0.001).
CONCLUSIONS: We have identified the presence of -29% PPBL cases in a series of consecutive patients with persistent leukocytosis/neutrophilia related to chronic cigarette smoking. Similar to the results obtained by other investigators, our PPBL patients showed a younger female predominance. Given the findings in our cohort, we believe that PPBL might be more common than previously thought and discuss further its potential implications for general and specialty practice.
Constantin A Dasanu; Ion Codreanu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Connecticut medicine     Volume:  76     ISSN:  0010-6178     ISO Abbreviation:  Conn Med     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-06-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372745     Medline TA:  Conn Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  69-72     Citation Subset:  IM    
Department of Hematology-Oncology, Saint Francis Hospital and Medical Center, Hartford, USA.
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