Bi clonal CLL

[wcm242]

When diagnosed with CLL in May 2018, the FISH test reported I have 2 different B cells that are multiplying, making my CLL bi clonal instead of mono clonal. I wish I could get feedback on others results of their bi clonal CLL. The test results said that my time to treatment may be shorter, but nothing else. Do any of you have info regarding bi clonal CLL? So far, my CLL is 13q deletion, mutated, and wbc count at 33k.

Thank you,

Michaelson

[AussieNeil Administrator]

Given you were told you had two different clones, I would expect that you should have a report somewhere detailing how those clones differ. It's usual for sub-clones to develop in CLL over time and with treatment, but in that case the sub-clones clearly arise from one parent clone. If both your clones are 13q deleted and mutated IgHV, even if they differ enough from each other to have separately originated, I would think that you still have very desirable prognostics. I would suggest your prognosis really comes down to what other deletions are present in the different clones.

Neil

[wcm242 in reply to AussieNeil]

Thanks for your reply. I am trying to learn all I can about this and appreciate you sharing your wisdom and knowledge on this site.

[avzuclav]

Welcome to the bi-clonal club. There's not much info out there. This German report concludes a trend to shorter time to first treatment, same as what you were told.

onlinelibrary.wiley.com/doi...

In my case, the two clones were reported on the IgVH mutation testing, with one clone using VH3-21 and the other using VH3-7.

[wcm242 in reply to avzuclav]

Thanks for sharing your experience with bi clonal CLL. How long ago were you diagnosed and have you had any treatments yet? As for myself, I have not, but have been feeling so exhausted everyday and feeling super swollen all over. I am going into my oncologist today for labs and see dr. in a few days. Looking forward to seeing what's up.

[avzuclav in reply to wcm242]

Almost five years since diagnosis for me. No treatment yet but if trends continue, probably in 2020 or 2021 (anemia & thrombocytopenia).

I don't think bi-clonal merits any additional worries, nor would I expect any clinician to give it much thought. I'm sorry to hear about your fatigue and swelling. I hope you get some answers.

Keep in mind, per iwCLL 2018 guidelines, fatigue can be a trigger for treatment:

"Significant fatigue (ie, ECOG performance scale 2 or worse; cannot work or unable to perform usual activities)."

[wcm242]

Thanks. Wish you the best also.

[Judyanne]

Hi,

I also have had 2 clones with different CD markers, both mutated and Trisonmy 12. Diagnosis changed to marginal zone from Sll but I had a long period of wait and watch from 2013 to 2018 and probably had lymphoma a few years before 2013. Doctors have never gotten excited about the two clones.