CIGARETTE-SMOKING AND CHRONIC POLYCLONAL B-CELL LYMPHOCYTOSIS

A syndrome associating a polyclonal increase of B-cells with binucleat e lymphocytes in peripheral blood and a polyclonal increase of serum I gM, accompanied or not by splenomegaly and lymphadenopathy, has been r eported in young to middle-aged women who are cigarette smokers. The m ajority of patients were HLA-DR7 positive and their clinical course re mained stable over periods of years. We report four cases of this synd rome. In all patients, DNA analysis provided additional evidence that the lymphocytosis was polyclonal, while in one patient who met all oth er symptomatic criteria the total lymphocyte count was normal. This wo uld suggest that unless careful attention is paid to the morphology of the lymphocytes, the syndrome may go undiagnosed.