Chronic lymphocytic leukemia: insights from lymph nodes & bone marrow and clinical perspectives [Kronična limfocitna leukemija: uvidi iz limfnog čvora i koštane srži i kliničke perspektive]

Jakšić, Ozren and Kardum-Skelin, Ika and Jakšić, Branimir (2010) Chronic lymphocytic leukemia: insights from lymph nodes & bone marrow and clinical perspectives [Kronična limfocitna leukemija: uvidi iz limfnog čvora i koštane srži i kliničke perspektive]. Collegium Antropologicum, 34 (1). pp. 309-313. ISSN 0350-6134

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Abstract

B-cell chronic lymphocytic leukemia (B-CLL) is characterized by highly variable distribution of tumor mass between peripheral blood, bone marrow and lymphoid organs which is important for staging, classification and prognosis. These clinical findings with novel data about importance of B-cell receptor and its stimulation with the support of microenvironment indicate important role of tissues (lymphoid organs and bone marrow) in the pathogenesis of B-CLL. Here is presented the novel approach of simultaneous characterization of B-CLL cells form peripheral blood, bone marrow and lymph nodes by flow cytometry and immunocytochemistry, defining inter- and intraclonal diversity with respect to various molecules. These include adhesion molecules (integrins, immunoglobulins, selectins), chemokine receptors (including CXCR-4), signaling molecules and prognostic factors (CD38 and ZAP-70), proliferation and apoptosis markers (including Ki67, AgNORs with PK index, survivin, bcl-2) and therapeutic targets (CD20 and CD52) and residual hematopoietic stem cells. A number of interesting significant interactions have been discovered, pointing to the important role of neoplastic cell microenvironment. These may in addition to insights in pathogenesis and roles of different microenvironments add to diagnosis, prognosis and treatment of B-CLL patients.

Abstract in Croatian

B-stanična kronična limfocitna leukemija (B-KLL) je obilježena izrazito varijabilnom raspodjelom tumorske mase između periferne krvi, koštane srži i limfnih organa, što je značajno određivanje kliničkih stadija, klasifikaciju i prognozu. Ovi kliničke značajke zajedno s novim nalazima o značaju B-staničnog receptora i njegove stimulacije uz potporu mikrookoliša ukazuju na značajnu ulogu tkiva (limfni organi i koštana srž) u patogenezi B-KLL-a. Ovdje prikazujemo novi pristup istodobnom karakterizacijom B-KLL stanica iz periferne krvi, koštane srži i limfnih čvorova protočnom citometrijom i imunocitokemijom i definiranjem inter i intraklonalne raznolikosti obzirom na adhezijske molekule (integrine, imunoglobuline, selektine), kemokinske receptore (uključujući CXCR-4), signalne molekule i prognostičke čimbenike (CD38 i ZAP-70), biljege povezane s kinetikom (Ki67, AgNOR, PK indeks), apoptozom (survivin, bcl-2), liječenjem (CD20, CD52) te rezidualne hematopoetske matične stanice. Ovakav pristup osim uvida u patogenezu može doprinijeti dijagnozi, prognozi i liječenju B-KLL bolesnika.

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