In contrast to the measurable risk of progression in patients with clinical CLL-like MBL, progression among patients with population-screening CLL-like MBL is exceedingly rare in the authors’ experience. As discussed in the prior sections, there is emerging data that the biology of population-screening MBL differs from that of CLL(8)(14) and clinical MBL and that population-screening MBL can be identified in up to 20% of the general population using highly sensitive assays.(9) Therefore, we believe that individuals with population-screening MBL likely do not have a risk of CLL that is substantially higher than that of the general population. Such patients do not require formal evaluation by a hematologist and surveillance beyond an annual examination by a primary care provider with complete blood count is not warranted.
