Scientists at the Institute for Medical Research at North Shore-LIJ have made a discovery that refutes two longstanding beliefs about the most common leukemia in the western hemisphere. Due to the relatively slow disease progression of chronic lymphocytic leukemia (CLL), doctors thought it was caused by a gradual accumulation of leukemia cells that could not die. The new findings, published online today in the Journal of Clinical Investigation, prove the exact opposite. The study will appear in the journals March 2005 print issue.
For decades, doctors and scientists believed that CLL was a static disease of long-lived white blood cells (lymphocytes) -- that the leukemia cells were both immortal and born at a slow rate, causing the slow rise in cell count over time. But researchers had been unable to find any problems with the leukemia cells process of cell suicide, called apoptosis, a normal part of the cell life cycle for which all cells are programmed. This was a hint that perhaps the leukemia cells were not immortal. Using a clever study design that required subjects only to drink water and give blood samples, the research team, led by Nicholas Chiorazzi, MD, director and CEO of the Institute for Medical Research, found that the leukemia cells are born at a fast rate and do indeed die. The slow rise in the cell count over time can be attributed to the difference between the birth and death rates of the cells, according to the study.
The scientists also found that there appeared to be a connection between poorer patient outcomes and the faster birth rates of the leukemia cells, regardless of the rate of cell death. "This particular finding may prove helpful in identifying patients who are at risk for worsening disease in advance of showing any clinical signs of deterioration," said Dr. Chiorazzi. He cautioned, however, that additional research is needed to establish its potential in guiding prognostic and treatment decisions. The study was small, examining 19 CLL patients.
Christina Verni | EurekAlert!
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