PREFERRED USAGE OF SPECIFIC IMMUNOGLOBULIN GENE SEGMENTS IN CHRONIC LYMPHOCYTIC-LEUKEMIA CELLS OF 3 HLA-IDENTICAL SISTERS

We report three family members, including a set of identical twins, who developed CD5 positive B-CLL. The patients are female Ashkenazi Jews sharing an identical HLA mal studies suggest a process of clonal evolution in one of the phenotype. Two of the HLA loci (B35 and Cw4) were twins. common with those already described as being shared by Ashkenazi Jews with an increased incidence of CLL, The rearranged immunoglobulin genes of the malignant cells of all three patients were found to express genetically related V-H regions belonging to the V-H(3) subgroup, and chromosomal studies suggest a process of clonal evolution in one of the twins.