Understanding the CLL micro-environment may ul... - CLL Support

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Understanding the CLL micro-environment may ultimately lead us to better control of the disease.

bkoffman profile image
bkoffmanCLL CURE Hero
13 Replies

In This Week’s Alert:

CLL Society's 2019 ASH interview with Dr. Brian Koffman in which Dr. Neil Kay reinforces the idea that the course of CLL is influenced not only by the tumor but also by the “micro-environment” in which it lives inside the bone marrow. Investigations into understanding this micro-environment may ultimately lead us to better control of the disease.


Hope this is helpful!

13 Replies
Ernest2 profile image

I'd never heard of TNF before.

Real interesting if a way could be found to block the excess production.

Best wishes,


Jm954 profile image
Jm954Administrator in reply to Ernest2

Anti TNFs used a lot as a treatment for arthritis, been around a long time. Another great example of a repurposed drug.


Ernest2 profile image
Ernest2 in reply to Jm954

Hi Jackie,

That's even better news then. Could a trial start then to see if it helps those in W&W control symptoms?

I see TNF have lots of nasty side effects, BUT if you are just regulating down to a healthy level perhaps you can avoid those to some extent. Tricky to know though what's going on in the marrow.

Best wishes to all,


Sushibruno profile image
Sushibruno in reply to Ernest2

I would like to know about this also, good question Ernest2.

bkoffman profile image
bkoffmanCLL CURE Hero in reply to Ernest2

I think Mayo is looking into such research.

Ernest2 profile image
Ernest2 in reply to bkoffman

Mayo, always seem to be leading the way at researching the important peripheral stuff.

Many thanks,


DriedSeaweed profile image
DriedSeaweed in reply to Ernest2

Sounds like from Dr. Kay's 2019 Lymphoma & Myeloma talk Dr. Fuhrman said, "a concern is triggering the risk of developing a richter's transformation." 23:20 youtu.be/yzTRCAcf2Ek

Jm954 profile image

This post is from 2 years ago but probably still helpful if members want to read some more.



Peggy4 profile image

Interesting. Thank you.


teakbank12 profile image

Also used for a long time with Crohn's patients.

I had Infliximab infusions around 2002 then again on 2015 but had a major reaction when going back on it which was one reason for starting FCR.


Hoffy profile image


This is very interesting. I often wondered if the CLL cause the Immune issues or the other way around.

It appears that the immune issues may cause the CLL. ( Maybe)

At a minimum if our immune system was really good it would not allow the CLL to start with!!

Be well, Thanks!


LovecuresCLL profile image
LovecuresCLL in reply to Hoffy

I think the mutations in the DNA of the lymphocyte progenitors cells is what is causing CLL. The tumor cells then affect the rest of the microenvironment including the other progeny (erythrocytes, monocytes and other cells). Anything can “cause” the leukemia mutations from radiation, toxins, viruses and drugs etc. The CLL tumor cells cause a chain reaction in the other cells.

It’s the chicken first rather than the egg, in my opinion. 😀

Hoffy profile image

True but it could be argued that we alway get mutation but limitation in our immune system allows the bad cancer CLL to stay around.

This is being studied. I am now UMRD so the CLL cells are not affecting the microenviroment that much but I still have lower levels of IgG, I gA, I gM and strangly high levels of IgE .

It is a chicken or the egg thing ,



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