ASH News Daily - Saturday, December 10, 2011 - (Page A-16)
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ASH NEWS DAILY
Image: colored scanning electron
micrograph (SEM) of a lung cancer cell.
CLL
Chronic Lymphocytic Leukemia:
More Soil Than Sod?
By Michael r. BiShop, Md
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5
we find some new dirt on this very
common hematologic malignancy.
We have come to learn that this disease
is not only about monoclonal B
cells, but about the environment in
which they live. The soil seems to be
as important as the sod, according
to Dr. Jan Burger from M.D. Anderson
Cancer Center in Houston, who
J
ust when it seemed we thought
we knew what chronic lymphocytic
leukemia (CLL) was,
will lead off the Education Program
on CLL with a session titled “CLL
and the Micro-Environment,” taking
place today from 9:30 to 11:00
a.m. in Hall AB of the San Diego
Convention Center.
For the past several years CLL re-
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search has focused on the leukemic
cells themselves; however, over the
past decade, it has become increasingly
clear that microenvironment
has significant affects on disease
progression in CLL as well as other
B-cell malignancies. It is now known
that both in the bone marrow and
lymphatic tissues, CLL engages in
interactions with stromal cells and
matrix, which collectively are referred
to as the “microenvironment.”
These interactions between CLL and
the microenvironment continue to
be defined, but what is known is that
these interactions impact CLL cell
survival and proliferation, conferring
resistance to conventional therapy.
In light of these effects, there has
been tremendous interest in therapeutically
targeting the microenvironment.
Our current knowledge of
these interactions and potential targets
for therapy will be highlighted
during Dr. Burger’s presentation.
We will also “dig deeper” as we
delve into new insights on the pathophysiology
of CLL from Dr. Peter
Hillmen from St James’s University
Hospital in Leeds. Dr. Hillmen’s
presentation will further focus on
the role of the microenvironment on
CLL maintenance and progression
through various receptors and pathways.
He will also review CLL molecular
markers and share how this
information is being used to stratify
patients into different treatment approaches,
introducing the concept
that our new understanding of the
pathophysiology of CLL is leading
to novel therapies and improved efficacy,
even in refractory patients.
Dr. Jennifer Brown from Dana-
Farber Cancer Institute will review
the current approaches to the management
of patients with CLL who
have failed to respond to or have relapsed
soon after receiving conventional
immune-chemotherapy. This
is a clinically important group of
patients, as they have a poor overall
survival in contrast to the perceived
survival among CLL patients. Traditionally
this poor-risk patient
population has been defined as having
diseases that either do not respond
or relapse within six months
of receiving fludarabine. However,
the definition is evolving with the
»» CLL Page A-18
Saturday, December 10, 2011
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