{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T01:24:00Z","timestamp":1784165040709,"version":"3.55.0"},"reference-count":26,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T00:00:00Z","timestamp":1600128000000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Academic Pacesetters Program of Shanghai Healthcare System","award":["2017BR033"],"award-info":[{"award-number":["2017BR033"]}]},{"name":"the National Key New Drug Creation Special Programs","award":["2017ZX09304-021"],"award-info":[{"award-number":["2017ZX09304-021"]}]},{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81570123"],"award-info":[{"award-number":["81570123"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,8,7]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Screening of monoclonal B-cell lymphocytosis (MBL) has improved the early detection of B-cell lymphoproliferative disorders (B-LPDs). This study was designed to find the most cost-effective way to screen for asymptomatic B-LPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A lymphocytosis screening project was conducted at a large-scale hospital among the Chinese population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>For 10 consecutive working days in 2018, 22 809 adult patients who received a complete blood count (CBC) were reviewed. These patients were selected from the outpatient, inpatient and health examination departments of a National Medical Centre in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 254 patients (1.1%, 254\/22 809) were found to have lymphocytosis (absolute lymphocyte count (ALC) &gt;3.5\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L). Among them, a population of circulating monoclonal B-lymphocytes were detected in 14 patients, with 4 having chronic lymphocytic leukaemia (CLL) and 10 having MBL, indicating an overall prevalence of 5.5% for B-LPD (3.9% for MBL). The prevalence of CLL among the elderly patients with lymphocytosis (\u226560 years) was determined to be 4.3% (4\/92). In the patients over 60 years of age, the prevalence of MBL was found to be 8.7%. CD5 (\u2212) non-CLL-like MBL was observed to be the most common subtype (8, 80%), followed by CLL-like phenotype (1, 10.0%) and atypical CLL phenotype (1, 10.0%). The receiver operating characteristic curve analysis for the CBC results revealed that the ALC of 4.7\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L may serve as the optimal and cost-effective cut-off for screening for early-stage asymptomatic B-LPD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In Chinese patients with lymphocytosis, there was a relatively high proportion of patients with CLL among individuals over 60 years of age. MBL is an age-related disorder. Non-CLL-like MBL was the most common MBL subtype, almost all of whom displayed a pattern of \u2018marginal zone lymphoma (MZL)-like\u2019 MBL. Lymphocytosis screening among the elderly would be effective in the detection of B-LPD and MBL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-036006","type":"journal-article","created":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T17:30:46Z","timestamp":1600191046000},"page":"e036006","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Screening for monoclonal B-lymphocyte expansion in a hospital-based Chinese population with lymphocytosis: an observational cohort study"],"prefix":"10.1136","volume":"10","author":[{"given":"Jiadai","family":"Xu","sequence":"first","affiliation":[{"name":"Hematology, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"Hematology, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Wei","sequence":"additional","affiliation":[{"name":"Hematology, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Wang","sequence":"additional","affiliation":[{"name":"Hematology, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9639-6606","authenticated-orcid":false,"given":"Peng","family":"Liu","sequence":"additional","affiliation":[{"name":"Hematology, Zhongshan Hospital, Fudan University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,9,15]]},"reference":[{"key":"2026062608023028000_10.9.e036006.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.08010.x"},{"key":"2026062608023028000_10.9.e036006.2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"2026062608023028000_10.9.e036006.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa075290"},{"key":"2026062608023028000_10.9.e036006.4","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.blre.2014.12.001","article-title":"The mystery of chronic lymphocytic leukemia (CLL): why is it absent in Asians and what does this tell us about etiology, pathogenesis and biology?","volume":"29","author":"Yang","year":"2015","journal-title":"Blood Rev"},{"key":"2026062608023028000_10.9.e036006.5","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-11-0038"},{"key":"2026062608023028000_10.9.e036006.6","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.leukres.2018.08.011","article-title":"Is there an epidemic of chronic lymphocytic leukaemia (CLL) in China?","volume":"73","author":"Yang","year":"2018","journal-title":"Leuk Res"},{"key":"2026062608023028000_10.9.e036006.7","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2009.287"},{"key":"2026062608023028000_10.9.e036006.8","first-page":"S10","article-title":"Prevalence of monoclonal B-cell lymphocytosis: a systematic review","volume":"78 Suppl 1","author":"Shim","year":"2010","journal-title":"Cytometry B Clin Cytom"},{"key":"2026062608023028000_10.9.e036006.9","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-02-585059"},{"key":"2026062608023028000_10.9.e036006.10","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-08-523704"},{"key":"2026062608023028000_10.9.e036006.11","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2003-09-3277"},{"key":"2026062608023028000_10.9.e036006.12","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1002\/hon.2461","article-title":"Spectrum and immunophenotyping of 653 patients with B-cell chronic lymphoproliferative disorders in China: a single-centre analysis","volume":"36","author":"Miao","year":"2018","journal-title":"Hematol Oncol"},{"key":"2026062608023028000_10.9.e036006.13","first-page":"S61","article-title":"Monoclonal B cell lymphocytosis in hepatitis C virus infected individuals","volume":"78 Suppl 1","author":"Fazi","year":"2010","journal-title":"Cytometry B Clin Cytom"},{"key":"2026062608023028000_10.9.e036006.14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2007.06870.x"},{"key":"2026062608023028000_10.9.e036006.15","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1080\/10245332.2017.1335969","article-title":"Monoclonal B-cell lymphocytosis in blood donors in turkey","volume":"23","author":"Ya\u011fc\u0131","year":"2018","journal-title":"Hematology"},{"key":"2026062608023028000_10.9.e036006.16","doi-asserted-by":"crossref","first-page":"e334","DOI":"10.1016\/S2352-3026(16)30192-2","article-title":"Monoclonal B-cell lymphocytosis in a hospital-based UK population and a rural Ugandan population: a cross-sectional study","volume":"4","author":"Rawstron","year":"2017","journal-title":"Lancet Haematol"},{"key":"2026062608023028000_10.9.e036006.17","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1007\/s00277-015-2409-9","article-title":"Hospital population screening reveals overrepresentation of CD5(-) monoclonal B-cell lymphocytosis and monoclonal gammopathy of undetermined significance of IgM type","volume":"94","author":"Voigtlaender","year":"2015","journal-title":"Ann Hematol"},{"key":"2026062608023028000_10.9.e036006.18","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1093\/ajcp\/aqz057","article-title":"Establishing absolute lymphocyte count thresholds for further review of peripheral blood lymphocytosis to Judiciously screen for monoclonal B-cell populations in older adults","volume":"152","author":"Muscara","year":"2019","journal-title":"Am J Clin Pathol"},{"key":"2026062608023028000_10.9.e036006.19","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/305239"},{"key":"2026062608023028000_10.9.e036006.20","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-07-515155"},{"key":"2026062608023028000_10.9.e036006.21","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1053\/j.seminoncol.2016.02.013","article-title":"What does it mean I have a monoclonal B-cell lymphocytosis?: recent insights and new challenges","volume":"43","author":"Scarf\u00f2","year":"2016","journal-title":"Semin Oncol"},{"key":"2026062608023028000_10.9.e036006.22","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13052"},{"key":"2026062608023028000_10.9.e036006.23","doi-asserted-by":"publisher","DOI":"10.21147\/j.issn.1000-9604.2018.01.01"},{"key":"2026062608023028000_10.9.e036006.24","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2012.743655"},{"key":"2026062608023028000_10.9.e036006.25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.07849.x"},{"key":"2026062608023028000_10.9.e036006.26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0052808"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-036006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T10:24:56Z","timestamp":1782728696000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-036006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":26,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,9,15]]},"published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1136\/bmjopen-2019-036006"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-036006","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9]]}}}