This week on the CLL Society website cllsociety.org, we share the first part of an interview from ASH 2014 with Dr. Jeff Sharman with a very interesting and easily understood explanation of the lifecycle of the B cell in the lymph nodes, bone marrow and bloodstream.
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Great video interview thanks Brian - and good to see you and Jeff having such fun doing it!
While anyone interested in how CLL cells accumulate will find this video interesting, I can highly recommend this interview to anyone starting Ibrutinib or Idelalisib treatment, as Dr Sharman gives an excellent explanation of how these drugs work. I particularly found his explanation into the very interesting new findings of how CLL cells move between their protected micro-environment where they proliferate and the blood supply and how our older research has misled us about how active CLL cells quite exciting. Basically, medical research scientists have harvested CLL cells for research from the peripheral blood (much easier than a node biopsy) and that's when they are in their exhausted state (after busily proliferating in the nodes etc) and when they non-responsive to B-Cell Receptor stimulation. That's lead everyone to think that they were basically inert all the time. That's definitely not the case when they are in their protected micro-environments!
Also fascinating was the finding that B-lymphocytes have an average replacement rate about the same as red blood cells, i.e. they last about 100 days in the blood stream. If CLL cells are disrupted from their cosy and stimulating micro-environments in the nodes, spleen and bone marrow, their numbers gradually decrease at about 1% per day (but it can vary between 0.5% and 3%), and that along with how much tumour bulk you have in your nodes, spleen and bone marrow and the rate at which they drift into your peripheral blood, (as I understand it) greatly determines how long it takes for your peak ALC to occur and how long it takes for it to drop to normal levels.
Perhaps research into CLL cells harvested from lymph nodes will eventually explain why many of us are so fatigued and why we get night sweats and have trouble regulating our body temperature?
Good to hear we'll still have something for CLL patients in Sydney. Unfortunately I won't catch up with you in person, but I've made arrangements to be available by phone.
Thanks. We just posted a great interview with Dr. Jeff Jones from OSU and the first newsletter out last week features a nice article by Dr. Byrd and an interview with Jennifer Brown.
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