Chronic lymphocytic leukemia: new insights into biology and therapy

Article Abstract:

Chronic lymphocytic leukemia is a blood cancer characterized by the overgrowth and accumulation of B lymphocytes, a type of immune cell. These cells appear to be mature but are underdeveloped biologically. The International Workshop on Chronic Lymphocytic Leukemia and the National Cancer Institute-Sponsored Working Group have developed guidelines for diagnosing chronic lymphocytic leukemia. Recent insights into the biology and treatment of this blood cancer are reviewed by analyzing 800 articles, abstracts, and book chapters, including 227 selected reports discussing the current issues in chronic lymphocytic leukemia. The abnormal B lymphocytes detected in patients with chronic lymphocytic leukemia develop from immune cells called CD5-B cells. These cells may be involved in autoimmunity, an abnormal condition in which the body's immune system attacks its own tissues. The disease process involves several steps, beginning with the increased production of CD5-B cells, followed by the transformation of a single cell. The disease is associated with abnormalities of certain chromosomes, specifically, trisomy 12, 14q+, 13q, and 11q. The presence of chromosome abnormalities is associated with a poor outcome. Three new drugs, fludarabine, pentostatin, and 2-chlorodeoxyadenosine, have been used to treat chronic lymphocytic leukemia, and bone marrow transplantation may offer a cure for this disease. Immunoglobulin, an immune protein, can be given intravenously to prevent or delay the development of moderate bacterial infections in patients with this cancer. Thus, major advances have been made in the knowledge and therapy of chronic lymphocytic leukemia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Development and progression, Drug therapy

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HLA-identical sibling bone marrow transplantation in younger patients with chronic lymphocytic leukemia

Article Abstract:

Bone marrow transplants into younger patients with chronic lymphocytic leukemia (CLL) from immune-matched siblings appear to be marginally successful. Researchers evaluated the effects of these transplants in 54 patients younger than 60 years of age with varying stages of CLL. The overall probability of survival at three years was 46%. Most patients received some form of treatment before transplantation, ranging from drug therapy to irradiation. Forty-nine percent of the patients who survived more than 100 days developed symptoms associated with graft-versus-host disease, even though all of these patients received drug therapy to prevent this disease. There was evidence of blood count normalization, absence of spleen and liver enlargement, and absence of lymph disease in 23 of the 24 surviving patients. Graft-versus-host disease, infection, transplant failure, or respiratory failure accounted for 25 of the 30 reported deaths.

Physiological aspects, Bone marrow, Bone marrow transplantation, Organ transplantation, Pediatric surgery, Transplantation of organs, tissues, etc. in children

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Genetic relatedness of lymphoid malignancies: transformation of chronic lymphocytic leukemia as a model

Article Abstract:

Certain types of B cells cancers may be genetically related to chronic lymphocytic leukemia. Genetically related means to arise from a genetically similar malignant cell. Approximately 10% of patients with chronic lymphocytic leukemia later develop a more aggressive B-cell cancer. A study reviewed 102 articles published in the medical literature that examined the genetic relatedness of different types of B-cell cancer and chronic lymphocytic leukemia. Approximately 50% of the cases of large B-cell lymphoma were not genetically related to a previous case of chronic lymphocytic leukemia. Some patients with acute lymphoblastic leukemia and multiple myeloma developed a genetically related form, and some patients did not. All the cases of prolymphocytic transformation developed from the same malignant cell as a previous case of chronic lymphocytic leukemia.

Genetic aspects, Lymphomas, Leukemia, Multiple myeloma

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