Chronic Lymphocytic Leukemia - The Leukemia & Lymphoma Society

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Lymph Nodes. Small structures, the size of beans that contain large numbers of lymphocytes and are connected with each other by small channels called “lymphatics.” These nodes are distributed throughout the body. Enlarged lymph nodes can be seen, felt or measured by computed tomography (CT) scan or magnetic resonance imaging (MRI) depending on their location and the degree of enlargement. In patients with lymphoma and some types of lymphocytic leukemia, the malignant lymphocytes grow and expand the lymph nodes so that they may become enlarged. Lymphocyte. A type of white cell that is the essential cell type in the body’s immune system. There are three major types of lymphocytes: B lymphocytes, which produce antibodies to help combat infectious agents such as bacteria, viruses and fungi; T lymphocytes, which have several functions, including assisting B lymphocytes in making antibodies; and natural killer (NK) cells, which can attack virus-infected cells or tumor cells. Macrophage. See Monocyte/Macrophage. Minimal Residual Disease (MRD). The small amounts of cancer cells that may remain after treatment, even when blood and marrow may appear to be normal. These residual cells can only be identified by sensitive molecular techniques. Monoclonal. See Clonal. Monocyte/Macrophage. A type of white cell that represents about 5 to 10 percent of the cells in normal human blood. The monocyte and the neutrophil are the two major microbe-eating and microbe-killing cells in the blood. When monocytes leave the blood and enter the tissue, they are converted to macrophages. The macrophage is the monocyte in action: It can combat infection in the tissue, ingest dead cells (in this function it is called a “scavenger cell”) and assist lymphocytes in their immune functions. Multidrug Resistance (MDR). A characteristic of cells that makes them resistant to the effects of several different classes of drugs. There are several forms of drug resistance. They are each determined by genes that govern how the cell will respond to the chemical agents. One type of multidrug resistance involves the ability to force several drugs out of cells. The outer wall of the cell contains a pump that ejects chemicals, preventing them from reaching a toxic concentration. The resistance to drugs can be traced to the expression of genes that direct the formation of high amounts of a protein that prevents the drugs from affecting the malignant cells. If the gene or genes involved are not expressed or are weakly expressed, the cells are more sensitive to the drug’s effect. If the genes are highly expressed, the cells are less sensitive to the drug’s effect. Mutation. An alteration in a gene that results from a change to a part of the stretch of DNA that represents the gene. A “germ cell mutation” is present in the page 36 I 800.955.4572 I www.LLS.org
egg or the sperm and can be transmitted from parent(s) to offspring. A “somatic cell mutation” occurs in a cell and can result in the growth of that specific tissue cell into a tumor. Most cancers start after a somatic mutation. In leukemia, lymphoma or myeloma, a primitive marrow (blood-forming) or lymph node cell undergoes a somatic mutation (or mutations) that leads to the formation of a tumor. If a mutation results from a major abnormality of chromosomes, such as a translocation, it can be detected by cytogenetic examination. Sometimes the alteration in the gene is more subtle and requires more sensitive tests to identify the original mutated cell (oncogene). Myelocyte. A cell of the marrow that is a precursor of the mature granulocytes of the blood. Myelocytes are not present in the blood of healthy individuals. Neutropenia. A decrease to a below-normal concentration of neutrophils, a type of white cell. Neutrophil. The principal phagocyte (microbe-eating cell) in the blood. The neutrophil is the main cell that combats infections. Patients with certain blood cancers or patients who have undergone chemotherapy often do not have sufficient quantities of neutrophils circulating in their bloodstream. A severe deficiency of neutrophils increases the patient’s susceptibility to infection. A neutrophil may be called a “poly” (polymorphonuclear neutrophil) or “seg”(segmented neutrophil) because its nucleus has several lobes. Nonmyeloablative Allogeneic Stem Cell Transplantation. See Reduced- Intensity Stem Cell Transplantation. Oncologist. A doctor who diagnoses and treats patients with cancer. Oncologists are usually internists who treat adults or pediatricians who treat children. Radiation oncologists specialize in the use of radiation to treat cancer. Surgical oncologists specialize in the use of surgical procedures to diagnose and treat cancer. These doctors cooperate and collaborate to provide the best treatment plan (surgery, radiation therapy, chemotherapy or immunotherapy) for the patient. Pancytopenia. A decrease to a below-normal concentration of all three of the major blood cell types: red cells, white cells and platelets. Pathologist. A doctor who identifies disease by studying tissues under a microscope. A hematopathologist is a type of pathologist who studies diseases of blood cells by looking at peripheral blood smears, bone marrow aspirates and biopsies, and lymph nodes and other tissues and uses his or her expertise to identify diseases such as CLL. In addition to the microscope, a hematopathologist also uses laboratory values, flow cytometry and molecular diagnostic tests to make the most accurate diagnosis. The hematopathologist works closely with the hematologist or oncologist who sees the patient and decides on the best treatment based upon the diagnosis. See Hematopathologist. Chronic Lymphocytic Leukemia I page 37
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 and 30: { { The neutrophils and monocytes a
Page 31 and 32: Medical Terms Allogeneic Stem Cell
Page 33 and 34: Bone Marrow Biopsy. A test to exami
Page 35 and 36: e counted. One use of flow cytometr
Page 37: HLA. The abbreviation for “human
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

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