B-CLL cells are monoclonal B-cell expansions as documented by the expression of monotypic (ie, either κ or λ) surface Ig and the CD19 antigen; this is in line with the presence of monoclonal rearrangement of VDJ genes in the leukemic cells. Most B-CLL cells also express activation markers and, like normal activated B-cells, have low levels of surface IgM and IgD. The expression of CD5, usually thought of as a lineage marker, is characteristic of B-CLL cells and should be considered part of their activation varies in different B-CLL cases.
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