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CLL Perspectives features the latest news and clinical information about CLL, brought to you in part by our advisory board of leading CLL experts. Access up-to-date clinical reviews, download educational resources and hear from our advisors on key topics in CLL. Our goal is to help you achieve better outcomes for your CLL patients. Learn more about us.
Featured Perspectives

Farrukh Awan, MD, MS
John C. Byrd, MD

Staging and Prognostic Factors in CLL

Thus far, no study has shown a survival advantage with early treatment in patients with CLL and a subset of CLL patients will never require therapy. This has led to the research efforts in CLL that have identified several specific biologic or clinical prognostic factors that predict time to progression and overall survival. With these recent...

Constantine S. Tam, MB, BS Susan Lerner, MS
Michael J. Keating, MB, BS

New Prognostic Markers in CLL

The recent proliferation of new "prognostic markers" in chronic lymphocytic leukemia (CLL) has provided valuable insights into the biology of the disease.1 In particular, significant survival differences when patients are classified by immunoglobulin heavy chain variable region (IGVH) mutation status2,3, fluorescent in-situ hybridization (FISH)...
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News & Commentary - provided by Medworm

 
Histone deacetylases mediate the silencing of miR-15a, miR-16, and miR-29b in chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL) demonstrates a global down-regulation of miR-15a and miR-16 and a selective silencing of the related miR-29b in aggressive disease. Deletions in chromosome 13 [del(13q14)] partially account for the loss of expression of miR-15a and miR-16, but the mechanisms by which miR-29b becomes silenced is unknown. In the present study, we show that the histone deacetylases (HDACs) are overexpressed in CLL and mediate the epigenetic silencing of miR-15a, miR-16, and miR-29b. HDAC inhibition triggered the accumulation of the transcriptionally activating chromatin modification H3K4me2 and restored the expression of miR-15a, miR-16, and miR-29b in approximately 35% of samples. Ectopic expression of miR-15a and miR-16 and HDAC inhibition–induced expression of miR-1...

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Source: Blood - Thursday, February 02, 2012

The Bruton tyrosine kinase inhibitor PCI-32765 thwarts chronic lymphocytic leukemia cell survival and tissue homing in vitro and in vivo

In this study, we analyzed the mechanism of action of PCI-32765 in CLL, using in vitro and in vivo models, and performed correlative studies on specimens from patients receiving therapy with PCI-32765. PCI-32765 significantly inhibited CLL cell survival, DNA synthesis, and migration in response to tissue homing chemokines (CXCL12, CXCL13). PCI-32765 also down-regulated secretion of BCR-dependent chemokines (CCL3, CCL4) by the CLL cells, both in vitro and in vivo. In an adoptive transfer TCL1 mouse model of CLL, PCI-32765 affected disease progression. In this model, PCI-32765 caused a transient early lymphocytosis, and profoundly inhibited CLL progression, as assessed by weight, development, and extent of hepatospenomegaly, and survival. Our data demonstrate that PCI-32765 effectively inhib...

Source: Blood - Thursday, February 02, 2012

Pathologic and Molecular Genetic Features of Chronic Lymphocytic Leukemia

Chronic lymphocytic leukemia (CLL) is an indolent B-cell leukemia. While many patients may not require therapy, some patients will suffer a progressive course and die of their disease. This clinical heterogeneity is reflected in the molecular genetic heterogeneity that is becoming apparent through studies of immunoglobulin heavy chain gene mutational status, chromosomal numerical abnormalities, microRNA abnormalities, and genetic abnormalities identified by whole genome sequencing. Indeed, many of these studies are becoming routine in the assessment of patients with CLL or being incorporated into clinical trials to further stratify patients for appropriate therapies. Here, we will review the morphologic, immunophenotypic, and molecular genetic features of CLL and touch upon the concept of ...

Source: Seminars in Oncology - Wednesday, February 01, 2012

IGHV gene mutational status and 17p deletion are independent molecular predictors in a comprehensive clinical-biological prognostic model for overall survival prediction in chronic lymphocytic leukemia

Conclusions: Data indicate that IGHV mutational status and 17p deletion may be integrated with clinical-demographic variables in new prognostic tools to estimate overall survival. (Source: Journal of Translational Medicine)

Source: Journal of Translational Medicine - Monday, January 30, 2012

Trisomy 12 and elevated GLI1 and PTCH1 transcript levels are biomarkers for Hedgehog-inhibitor responsiveness in CLL

Hedgehog (HH) signaling is activated in various lymphoid malignancies, but conflicting results exist about its role in chronic lymphocytic leukemia (CLL). Here, we demonstrate that the expression of essential HH pathway components like GLI1, PTCH1, and the HH ligands is highly diverse in CLL. A subset of 36.7% of 60 tested CLL samples responded to all 3 SMOOTHENED (SMO) inhibitors, whereas 40% were completely resistant. Responsiveness correlated with elevated GLI1 and PTCH1 transcript levels and the presence of trisomy 12, whereas no other karyotype correlated with responsiveness. All trisomy 12 CLLs displayed constitutive HH pathway activation driven by autocrine DESERT HH (DHH) ligand secretion, which could be blocked by the HH-blocking Ab 5E1. Cocultures with DHH-expressing BM stromal c...

Source: Blood - Thursday, January 26, 2012