Autoimmune Link

[PointReyes]

What is the link of autoimmune disorders and CLL? Is one susceptible to CLL if they have had autoimmune disease?

[Sushibruno]

My optomologist asked me this very same question today, and I told her that I did hear this before and I do believe there's a link. I also have lupus.

[lankisterguy Volunteer]

Probably the easiest way to express it is to say that CLL upsets all of our immune systems, but rarely in the same way. -

Most of us have low resistance to bacterial, viral and fungal infections, but many of us also have exaggerated autoimmune problems, some with Rheumatoid Arthitis, Psoriasis, and especially when the immune system decides to destroy red blood cells (AIHA) or platelets (ITP)

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lls.org/support/other-helpf...

cllsociety.org/2017/04/auto...

ncbi.nlm.nih.gov/pmc/articl...

medscape.com/answers/199313...

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Len

[bennevisplace in reply to lankisterguy]

Thanks Len.

So the risk of getting autoimmune disease is increased by disruption of the immune system in blood cancers - your refs above.

The risk of getting autoimmune disease is also increased by some common viruses nih.gov/news-events/nih-res...

ncbi.nlm.nih.gov/pmc/articl...

The risk of getting viral infection or activation is increased by disruption of the immune system in blood cancers lls.org/leukemia/chronic-ly...

CLL + virus : risk on risk. One wonders...

[PointReyes in reply to lankisterguy]

Thank you !

[Palmetto in reply to PointReyes]

I believe there is some genetic link although of course I can't prove it. Husband has vitiligo which is an autoimmune disease and then later in life developed CLL. I believe it is all interrelated.

[Smakwater in reply to Palmetto]

A certain research doctor told me that many of the relationships that appear to show up in observation are what they refer to as passengers rather than drivers. This is a complex study and much of what was theorized in the recent past is now a broader investigation.

As recent as the 1990's it was thought that there was a connection between EBV and CLL.

ncbi.nlm.nih.gov/pmc/articl...

JM

[AutumnJ]

Hi Point Reyes,I just wanted to add, that I went to my GP initially with 'Raynaud's' like symptoms. My blood tests identified CLL. My haem onc said that the link was ' poorly understood' which I think is doctor speak for 'we don't know for certain'.

[Dawn-Marie]

I have been dx with psoriasis since I was a little girl. Now in 2017 CLL. My dermatologist said it’s possible the psoriasis caused the CLL??

[Phil4-13 in reply to Dawn-Marie]

Dawn-Marie, your dermatologist’s thought of a possible link between psoriasis and CLL made me think, “WOW!” I haven’t had psoriasis, but hearing that connection is intriguing. We are searching for answers and so are the doctors! Sandra😮

[SlowCLL]

Hi PointReyes et al,

This is a summary of a recent 30 page in depth discussion of the links between B cell immune system dysfunction, CLL, and autoimmune issues. It is heavy lifting, but worth the effort.

Owen

ncbi.nlm.nih.gov/pmc/articl...

Common Variable Immune Deficiency: Dissection of the Variable Charlotte Cunningham-Rundles, M.D., PhD*

Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, New York.

Summary

Starting about 60 years ago, a number of reports appeared that outlined the severe clinical course of a few adult subjects with profound hypogammaglobinemia. Puzzled by the lack of family history and adult onset of symptoms in most, the name “acquired” hypogammaglobinemia was given, but later altered to the current name common variable immune deficiency (CVID). Pathology reports remarked on the loss of lymph node architecture and paucity of plasma cells in lymphoid tissues in these subjects. While characterized by reduced serum IgG and IgA and often IgM, and thus classified amongst the B cell defects, an increasing number of cellular defects in these patients have been recognized over time. In the early years, severe respiratory tract infections commonly led to a shortened life span, but the wide spread availability of immune globulin concentrates for the last 25 years has improved survival. However, chronic non-infectious inflammatory and autoimmune conditions have now emerged as challenging clinical problems; these require further immunologic understanding and additional therapeutic measures. Recent study of this phenotypic syndrome have provided an increasingly fertile ground for the identification of autosomal recessive and now more commonly, autosomal dominant gene defects which lead to the loss of B cell development in this syndrome.

[Italianpainter]

My oncologist told me that there is a definite link to autoimmune disease and Cll. I asked that question of my internist more than 30 yrs ago and there was no proof. But now the understanding is that autoimmune diseasea is normal cells gone wild. Thats what CLL and all cancer is.

[AussieNeil Administrator in reply to Italianpainter]

During the maturation process of B-cells, aided by helper T-cells, B-cells go through what's termed somatic hyper-mutation. During this process, the B-cell DNA in the genes that make the B-Cell Receptor (the part that recognises antigens - the unique protein structures on viruses, bacteria and fungi, etc) are rearranged. This is the process by which B-cells can differentiate to form B-cells specific to all the different infections we encounter in our lifetime, enabling us to fight off these infections - our so called adaptive immunity. The somatic mutation process is random, with the T-cells working with the B-cells to select out B-cells that are specific to a new infection and encourage their propagation. Sometimes that random generation of a B-Cell Receptor results in the creation of B-cells that specifically recognise a body cell. If those B-cells are not recognised and repurposed, auto-immune disease develops. Strangely, with CLL, the resulting auto-immunity is primarily specific to other blood cell types, most often red blood cells and platelets. That's why Auto-immune Haemolytic Anaemia (AIHA) and Immune Thrombocytopenia (ITP) are more common with CLL than in the general population.

Neil