# Biological characteristics and clinical significance of stereotyped B-cell receptor in chronic lymphocytic leukemia

## TL;DR

This paper reviews the biological and clinical significance of stereotyped B-cell receptors in chronic lymphocytic leukemia.

## Contribution

It provides a comprehensive overview of stereotyped BCR subgroups and their clinical relevance in CLL.

## Key findings

- Over 40% of CLL patients show biased IGHV usage and similar HCDR3 sequences.
- Subgroups like #2 and #8 have distinct biological and clinical features.
- Stereotyped BCR patterns are linked to prognosis and Richter transformation risk.

## Abstract

慢性淋巴细胞白血病（CLL）是西方成人最常见的白血病，尽管CLL在亚洲人种中发病率偏低，但随着人口老龄化，CLL发病率在我国呈上升趋势。CLL细胞与微环境的交互中，B细胞受体免疫球蛋白（B-cell receptor immunoglobulin，BCR IG）对抗原的识别起重要作用，免疫球蛋白重链可变区（IG heavy variable region，IGHV）的突变状态更是判断CLL预后的经典标志物。超过40％的CLL患者间存在IGHV的偏向性使用和高度相似的重链可变区互补决定区3（heavy complementarity-determining region 3，HCDR3）氨基酸片段，此现象称为同型模式BCR。不同亚群的同型模式BCR存在独特的生物学和临床特征。其中IGHV有突变但预后差的#2亚群和发生Richter转化风险高的#8亚群被欧洲CLL研究启动组推荐纳入IGHV突变状态的临床报告之中。本文综述CLL中同型模式BCR的定义、分布、生物学特征和临床意义。