Monday, February 14, 2011

It's the Nodes, Stupid

I am not big on sharing studies here. There are other sites that I have listed before that are much better at that than this blog,


I share this to share with you some of what gets me excited. Most of the research that I read on CLL, and that is several articles everyday, are not immediately pertinent and nearly all are downright dull.

However for me, this recent study answers the questions as to where my cancer, chronic lymphoid leukemia, is doing most of its growth. And from that it is my opinion, we learn where it must wiped cleaned or there is no chance for a cure.


What this research says to me if that the cancer is most active in the nodes and the spleen, essentially a big node. That fits completely with my own experience. My CLL (after my transplant) came back in my nodes first, my hidden nodes deep in my guts. This is most obvious in those like me with 11q del that tend to have bulky nodes, but is true for all with CLL.


This has important implications for me and any CLLer. If I want a cure, which I sure as heck do, I need to get rid of all the proliferative centers in all the nodes.

Hopefully this small step will be followed soon, with the article that announces the path to the cure.


Proliferative index and expression of CD38, Zap-70, and CD25 in different lymphoid compartments of chronic lymphocytic leukemia patients

Original Research

(423) Article views

Authors: Olga Khoudoleeva, Eugeny Gretsov, Natasha Barteneva, et al

Published Date January 2011 , Volume 2011:3 Pages 7 - 16 DOI 10.2147/PLMI.S14752

Olga Khoudoleeva1 Eugeny Gretsov1 Natasha Barteneva2,3 Ivan Vorobjev1
1Hematology Scientific Center, Russian Academy of Medical Sciences, Moscow, Russia; 2Immune Disease Institute and Program in Cellular and Molecular Biology, Children Hospital of Boston, Boston, MA, USA; 3Department of Pathology, Harvard Medical School, Boston, MA, USA

Abstract: Recent studies of chronic lymphocytic leukemia (CLL) show that malignant B cells proliferate at a rate similar to normal B lymphocytes. This is in apparent contradiction to the very low proliferation rate found in blood specimens from CLL patients. To address this problem, we studied the expression of Ki-67, CD38, CD25, and Zap-70 in different compartments of CLL patients. Using triple-color flow cytometry, we examined the expression of CD38, CD25, Zap-70, and Ki-67 antigens in the peripheral blood, bone marrow, spleen, and lymph nodes biopsies of patients with CLL, splenic marginal zone lymphoma (SMZL), and nonmalignant diseases. In parallel probes of lymph node/spleen biopsies and blood taken from one and the same patient, Ki-67 expression was 17 times higher. Among the whole cohort, we also found significantly higher Ki-67 expression in biopsies from lymph nodes and spleen (4.95% ± 0.55%), compared with bone marrow (1.88% ± 0.32%) and peripheral blood (0.45% ± 0.03%,). We show for the first time that proliferation of B lymphocytes in CLL patients is associated primarily with lymph nodes/spleen.
Malignant cells in the blood represent only a subpopulation of nonproliferating and less-activated B cells in this disease.

Keywords: chronic lymphoid leukemia, CD38, Zap-70, Ki-67, bone marrow, lymph node

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3 Comments:

Anonymous Anonymous said...

Very interesting and leans me even more toward the new agents, PCI-32765 and CAL-101. From anecdotal comments by patients in their trials, nodes and spleens get reduced very quickly. PB .. not so fast. But this work seems to be saying that clearing nodes and spleens is most important.

Thanks for your post,
Lynn S.

February 15, 2011 at 2:17 PM  
Anonymous Anonymous said...

Dr. Koffman

Can you tell me what the average size node is. What size is dangerous and tells you that cancer is possibly back.

February 17, 2011 at 4:47 PM  
Anonymous Anonymous said...

What size should normal nodes be? What size do you look for when there might be cancer involved?

Thank You

February 19, 2011 at 6:02 PM  

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