PURPOSE OF REVIEW
Normal B cells that failed to productively rearrange immunoglobulin V region
genes, encoding a functional B cell receptor (BCR) are destined to die. Likewise, the
majority of B cell malignancies remain dependent on functional BCR signaling, while in
some subtypes BCR expression is missing and, apparently, counterselected. Here we
summarize recent the experimental evidence for the importance of BCR signaling and
clinical concepts to target the BCR pathway in B cell leukemia and lymphoma.
RECENT FINDINGS
While the dependency on pre-BCR signaling in pre-B acute lymphoblastic leukemia
(ALL) seems to be limited to few ALL subtypes (e.g. TCF3-PBX1), most
mature B cell lymphomas rely on BCR signaling provided by different stimuli e.g. tonic B
cell signaling, chronic (auto)-antigen exposure, and self-binding properties of the BCR.
The finding that in chronic lymphocytic leukemia (CLL), BCRs bind to an epitope on the
BCR itself unravels a novel concept for CLL pathogenesis.
SUMMARY
Targeting of the B cell receptor tyrosine kinases SYK, BTK, and PI3K achieve
promising clinical responses in various mature B cell malignancies and might also be
useful in defined subsets of ALL. However, further understanding of the BCR signal
integration in the different disease groups are required to accurately predict, which
groups of patients will benefit from BCR pathway-inhibition.