Dr Ferrarini stressed that CLL is not an accumulation disease as was thought many years ago; it is a disease of immunocompetent B cells and antigen stimulation plays a major role.
The importance of VH gene mutation or not is well recognized and it is known that CLL cells have a special BCR repertoire. Identical BCR have been identified in CLL cells from different patients in different countries, thus leading to the hypothesis that the selection could be made by a special as yet unidentified antigen.
What is the origin of the B-CLL cells?
One plausible hypothesis is that the marginal zone of the lymph node gives rise to B-CLL cells.
Dr Stilgenbauer analyzed the genetic abnormalities predicting poor outcome: amongst them 17 p- and 11q-, thymidine kinase > 10 U/ml and no VH gene mutation are adverse prognosic factors whereas 13q+ is associated with a favorable prognosis.
Dr Hillmen discussed novel treatment strategies. The combination of Fludarabine-Cyclophosphamide is the new gold standard for front line therapy.
Last updated on Saturday 17 June 2006.