CLL is only about lymphocytes? Perhaps not... monocyte/macrophage may play a role

CLL is only about lymphocytes?  Perhaps not... monocyte/macrophage may play a role

From this study...

'CLL patients have leukemic cells expressing high levels of immune-suppressing factors, low levels of adhesion and co-stimulatory molecules, lower numbers of natural killer cells, and deregulated T cells with an impairment of immunological synapse formation. The alterations described in our study further contribute to characterizing the complexity of factors potentially involved in the acquired immune deficiency of CLL patients.

In conclusion, we detected altered composition and deregulation of genes involved in phagocytosis and inflammation in blood monocytes obtained from CLL patients, suggesting that CLL-mediated “education” of immune elements may also include the establishment of a skewed phenotype in the monocyte/macrophage population.'

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  • According to the paper, we don't even fully know what monocytes do in healthy people!

    "The full spectrum of monocyte functions, and in particular the specific functions of different monocyte subsets, is not completely known but comprises anti-inflammatory properties, tissue repair and angiogenesis."

    Good to see researchers chipping away at these knowledge boundaries - who knows what may come out of it? Perhaps a greater understanding of the protective microenvironment CLL cells weave around them which could lead to improved prognosis and treatment.



  • Thanks for this Chris..

    But what is written above brings out this word heterogeneous again doesn’t it.?

    There is so much going on with our CLL that we are bound to be different, and with different outcomes..

    AND, to use your own well-worn phrase ‘ There is much we still do not know ‘.


  • I have no idea what monocytes are, but I just did a blood profile and the monocytes are way too low. Will ask my doctor what it means and listen to his usual "wait and watch" reaction1

  • There was a recent paper that found a correlation between a HIGH monocyte count at CLL diagnosis and a poorer prognosis.

    " A monocyte count >0.91×109 L-1 at the time of diagnosis was associated with a shortened overall survival and treatment-free survival."

    From Leukemia Research 37:614–618 "Another prognostic indicator for CLL - the monocyte count", by Mazumdar R, Evans P, Culpin R, Bailey J, Allsup D [2013]

    My monocyte count has only been (barely) into the normal range [0.2 to 0.8] twice in over 40 blood tests since my diagnosis. It averages 0.06.

    My low count monocyte has never been mentioned by my haematologist despite impaired immunity being the major impact on my quality of life with CLL. Neutrophil levels are however closely monitored.

    I'll be interested to hear what answer you get. In the mean time, I hope you find the above reassuring.


  • I am reassured.... sort of...

  • To save everyone diving for Wikipedia, etc, here are my notes on what monocytes do:

    Monocytes increase during severe infections, and other conditions. They remove debris and microorganisms by phagocytosis (engulfing them). Monocytes and Neutrophils come from a common moncyte/granulocyte (i.e neutrophil) progenitor. Your spleen contains about half of your reserve of monocytes (too bad if you've had a splenectomy).

    Chaya Venkat explains monocytes thus:

    If neutrophils are first responders to a crisis, think of monocytes as the instant responders. In neutropenic patients the very first cell line that the bone marrow is able to get out there onto the battle front are monocytes.

    Monocytes are the precursors of dendritic cells and macrophages – literally garbage monsters that can eat bacteria and other other pathogens alive. Dendritic cells are essential for alerting T-cells to the exact nature of the enemy.

    Without dendritic cells telling them what to fight, T-cells are blind and unable to mount an effective attack strategy.

    Full details:

  • Interesting discussion....thanks.

    I think this paper is pointing out a possible way in which our CLL immune systems become deficient.

    It is more a 'what if' and I wouldn't worry about my monocyte counts... rather understand the fact that our immune systems are 'broken' to some extent...


  • First time I've read the phrase 'acquired immune deficiency'... I think it will help me to explain to others what living with CLL means.


  • Our immune deficiency is aquired in the sense of CLL causing it, but Acquired Immune Deficiency Syndrome is AIDS...

    You might want to be a little cautious with the term Bev... ;-)


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