CLL lies at the crossroads of hematology

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Rev Clin Exp Hematol 2000 Mar;4(1):5-21 Related

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Biology of chronic lymphocytic leukemia.

Caligaris-Cappio F.

Divisione Universitaria di Immunologia Clinica,

Ospedale Mauriziano Umberto I, Dipartimento di Scienze

Biomediche e Oncologia Umana, Universita di Torino,

Torino, Italy.

B-cell chronic lymphocytic leukemia (CLL) lies at the

cross-roads of hematology, immunology and oncology for

at least three major reasons: (a) it is the prototype

of human malignancies that primarily involve defects

in the induction of apoptosis; ( CLL patients

develop a severe immunodeficiency with progressive

hypogammaglobulinemia; and © they have a high

prevalence of autoimmune phenomena. Recent advances in

the biology of the malignant cell in CLL lead to a

scenario comprised of two basic elements: first, CLL

cells are optimally organized to survive in their

niches because their ability to undergo apoptosis is

severely hampered; second, they have a

microenvironment-dependence that promotes their

extended survival, a situation that arises most

probably through direct cell-to-cell contacts. In

addition, CLL cells themselves are the major accessory

cells in CLL, but are inefficient antigen-presenting

cells. This latter defect may provide a clue to

reinterpret the events of immunodeficiency and

autoimmunity.

PMID: 11491097 [PubMed - in process]

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