Spontaneous clinical regression in chronic lymphocytic leukaemia

Abstract

Chronic lymphocytic leukaemia (CLL) is a B-cell disorder, which has a median survival of over 10 years from diagnosis for stage A disease. The natural history of stage A disease is generally indolent or only slowly progressive. It is less well known that CLL may undergo spontaneous regression. We report a series of 10 such cases (eight stage A and two stage B) followed at our institutions.

Spontaneous regression of chronic lymphocytic leukemia: clinical and biologic features of 9 cases

“…Recognized since the 1970s, 18,19 this phenomenon has been rarely described in the literature. In the largest series of spontaneous regressions, 10 as well as in smaller series from other groups, no exhaustive data on the biologic features of the disease are reported.…”

“…In the literature, there are only a few papers in which this phenomenon has been reported. [7][8][9][10][11] The clinical features of these cases have been described, but there is no information on the biologic markers of their disease or on the pathogenesis of this event. Particularly, it is not known whether there are distinctive features that can identify among patients with good prognosis those who may experience over time a spontaneous regression of their disease.…”

Ablative RT protects immune responses

“…Calreticulin has been recognized as a radiation-inducible protein, and roles in apoptosis, antigen presentation, and signaling dendritic cells have been attributed to this protein. 5,6 The report of differential effects of ablative radiation therapy as compared with fractionated radiation therapy or with the addition of adjuvant chemotherapy on T-cell responses offers critical clinical implications to be considered in the design of future combined modality therapeutic strategies. Can it be that the incremental progress anticipated from combining modalities is actually counterproductive in clinical settings conducive to a favorable immune response associated with radiation therapy?…”

Secondary primary malignancy presence and related factors in chronic lymphocytic leukemia

“…While quite rare, spontaneous clinical regression has been reported (3). The most characteristic finding of CLL is lymphocytosis in peripheral blood and bone marrow, and a persistent absolute lymphocyte count > 5000/μL, which is important for the diagnosis of CLL.…”