Chronic Lymphocytic Leukemia - The Leukemia & Lymphoma Society

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Some stem cells also enter the blood and circulate. They are present in such small numbers that they cannot be counted or identified by standard blood count tests. Their presence in the blood is important because they can be collected by a special technique. There are also methods to induce more stem cells to leave their home in the marrow and circulate in the blood, allowing a greater number of stem cells to be collected. If enough stem cells are harvested from a compatible donor, they can be transplanted into a recipient. Stem cell circulation, from marrow to blood and back, also occurs in the fetus. After birth, placental and umbilical cord blood can be collected, stored and used as a source of stem cells for transplantation. The Lymphatic System The marrow is really two organs in one. The first is the blood cell–forming organ. The second is the lymphocyte-forming organ and is a part of the immune system. The marrow produces three main types of lymphocytes: { { B lymphocytes (B cells), which make antibodies in response to foreign antigens, especially microbes { { T lymphocytes (T cells), which mature in the thymus. The T lymphocytes have several functions, including assisting B lymphocytes to make antibodies against invading bacteria, viruses or other microbes. The antibody attaches to the microbe, making it possible for other white cells to recognize the antibody and pull it into the cell (ingest it) along with its attached microbe. The white cell then kills and digests the microbe { { Natural killer (NK) cells, which attack virus-infected cells without requiring an antibody or other mediation. T cells and NK cells have other functions as well and are important elements in research efforts to design immunotherapies to treat lymphoma and other cancers. The lymphocytes circulate through channels called “lymphatics,” which connect the lymph nodes to each other throughout the body. The lymphatic channels collect into large ducts that empty into blood vessels. Lymphocytes enter the blood via these ducts. Most lymphocytes are found in the lymph nodes and other parts of the lymphatic system such as the skin; spleen; tonsils and adenoids (special lymph nodes); intestinal lining; and, in young people, the thymus. page 28 I 800.955.4572 I www.LLS.org
Medical Terms Allogeneic Stem Cell Transplantation. A treatment that uses donor stem cells to restore a patient’s marrow and blood cells. First, the patient is given conditioning therapy (high-dose chemotherapy or high-dose chemotherapy with total body radiation) to treat the leukemia and to “turn off” the patient’s immune system so that the donor stem cells will not be rejected. A type of transplant called a “nonmyeloablative” or “reduced-intensity” transplant is under study. It uses lower doses of conditioning therapy and may be safer, especially for older patients. For more information, see the free LLS booklet Blood and Marrow Stem Cell Transplantation. Anemia. A decrease in the number of red cells and, therefore, the hemoglobin concentration in the blood. This results in a diminished ability of the blood to carry oxygen. If severe, anemia can cause a pale complexion, weakness, dizziness, fatigue and shortness of breath on exertion. Antibodies. Proteins released by plasma cells (derived from B lymphocytes) that recognize and bind to specific foreign substances called “antigens.” Antibodies coat, mark for destruction or inactivate foreign particles, such as bacteria, and viruses or harmful toxins. Antibodies can also be made in the laboratory, in two ways. Material from species is injected into a different species; the receiving species recognizes the materials as foreign and make antibodies to it. These antibodies are usually polyclonal antibodies; that is, they react to multiple targets (antigens). The second method involves monoclonal antibodies, which react to only one target (antigen) and can be used in several important ways. They can be used to identify and classify types of blood cancers or they can be altered to make them useful in antibody-mediated immunotherapy. Apheresis. The process of removing certain components of a donor’s blood and returning the unneeded parts to the donor. The process, also called “hemapheresis,” circulates blood from a donor through a specialized machine, and then back to the donor. Apheresis makes it possible to remove desired elements from large volumes of blood. Platelets, red cells, white cells and plasma can be removed separately. This procedure is also used to remove circulating blood stem cells, which can be frozen, stored and later used for transplantation instead of marrow stem cells. See Platelet Transfusion. Autologous Stem Cell Transplantation. A treatment that uses a patient's own stem cells to delay the progression of certain blood cancers. The autologous transplantation process takes place after the patient achieves a complete response (remission), or a good partial response, to induction drug therapy. In this treatment 1) the patient’s stem cells are harvested, usually from the blood; 2) the stem cells are frozen for later use and the patient receives conditioning drug therapy; and 3) the stem cells are thawed and infused back into the patient through an indwelling catheter (central line). Patients receive supportive care to help prevent Chronic Lymphocytic Leukemia I page 29
Page 1 and 2: Chronic Lymphocytic Leukemia JUNE D
Page 3 and 4: Table of Contents 2 Introduction 2
Page 5 and 6: along with a cancer diagnosis. LLS
Page 7 and 8: We’d Like to Hear From You. We ho
Page 9 and 10: etween herbicides used in Vietnam a
Page 11 and 12: infrequently, cause an increase in
Page 13 and 14: Chromosomal Changes. Certain chromo
Page 15 and 16: Treatment Current therapies do not
Page 17 and 18: Chemotherapy. Chlorambucil (Leukera
Page 19 and 20: Table 3. Some Drugs Used to Treat C
Page 21 and 22: Prolymphocytes. About 15 percent of
Page 23 and 24: Kinase Inhibitor Therapy. Kinases a
Page 25 and 26: The National Cancer Institute-spons
Page 27 and 28: Table 5. CLL and Related Diseases L
Page 29: { { The neutrophils and monocytes a
Page 33 and 34: Bone Marrow Biopsy. A test to exami
Page 35 and 36: e counted. One use of flow cytometr
Page 37 and 38: HLA. The abbreviation for “human
Page 39 and 40: egg or the sperm and can be transmi
Page 41 and 42: Promyelocyte. A cell that is formed
Page 43 and 44: More Information Free LLS publicati
Page 45 and 46: Notes Chronic Lymphocytic Leukemia
Page 47 and 48: REACH OUT TO OUR INFORMATION SPECIA

Chronic Lymphocytic Leukemia - The Leukemia & Lymphoma Society

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