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He (Twin A) was also found to have an asymptomatic B\u2010cell chronic lymphocytic leukaemia (B\u2010CLL). Although JAK2\u2212, Twin B was subsequently shown to have a benign monoclonal B\u2010cell lymphocytosis (<jats:styled-content style=\"fixed-case\">MBL<\/jats:styled-content>). Flow cytometric and molecular analyses of the B\u2010cell compartments revealed different immunoglobulin light and heavy chain usage in each twin. We hypothesized that whole exome sequencing could help delineating the pattern of germline B\u2010cell disorder susceptibility and reveal somatic mutations potentially contributing to the differential patterns of pre\u2010malignancy. Comparing bone marrow cells and T cells and employing in\u2010house engineered integrative analysis, we found aberrations in Twin A consistent with a myeloid neoplasm, i.e. in <jats:italic>TET2<\/jats:italic>,<jats:italic> RUNX1<\/jats:italic>,<jats:italic> PLCB1<\/jats:italic> and <jats:italic>ELF4<\/jats:italic>. Employing the method for detecting high\u2010ranking variants by extensive annotation and relevance scoring, we also identified shared germline variants in genes of proteins interacting with B\u2010cell receptor signalling mediators and the WNT\u2010pathway, including <jats:italic>IRF8<\/jats:italic>,<jats:italic> PTPRO<\/jats:italic>,<jats:italic> BCL9L<\/jats:italic>,<jats:italic> SIT1<\/jats:italic> and <jats:italic>SIRPB1<\/jats:italic>, all with possible implications in B\u2010cell proliferation. Similar patterns of <jats:italic>IGHV<\/jats:italic>\u2010gene usage to those demonstrated here have been observed in inherited acute lymphoblastic leukaemia. Collectively, these findings may help in facilitating identification of putative master gene(s) involved in B\u2010cell proliferations in general and <jats:styled-content style=\"fixed-case\">MBL<\/jats:styled-content> and B\u2010<jats:styled-content style=\"fixed-case\">CLL<\/jats:styled-content> in particular.<\/jats:p>","DOI":"10.1111\/bjh.13305","type":"journal-article","created":{"date-parts":[[2015,3,5]],"date-time":"2015-03-05T23:04:50Z","timestamp":1425596690000},"page":"391-400","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Nature and nurture: a case of transcending haematological pre\u2010malignancies in a pair of monozygotic twins adding possible clues on the pathogenesis of B\u2010cell proliferations"],"prefix":"10.1111","volume":"169","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3083-4850","authenticated-orcid":false,"given":"Marcus 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