Publication: Estudio del papel de las interacciones Eph-ephrin en los microambientes de médula ósea en la leucemia linfática crónica
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2018-09-24
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Universidad Complutense de Madrid
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Abstract
La leucemia linfática crónica (LLC) es el síndrome proliferativo más común en el mundo occidental. Esta enfermedad se caracteriza por la acumulación de linfocitos B maduros en sangre periférica (SP), médula ósea(MO), ganglios linfáticos (GL) y bazo (B) (Moreno y cols., 2008). Las células LLC expresan de forma característica CD 5, antígeno relacionado con células T,junto con CD 19 y CD 23. Mientras que sus niveles de CD 20 son bajos y carecen de la expresión de CD10, lo que permite diferenciarlas de las células del linfoma del manto. Así mismo, sus niveles de inmunoglobulinas en la superficie celular son muy bajos, normalmente sólo IgM y/o IgD. La infiltraciónde médula ósea ocurre en todos los pacientes desde el inicio de la patología,llegando a representar más de un 30% de la celularidad (Hallek y cols., 2008).El patrón de infiltración varía desde nodal o intersticial a difuso, o una condición mixta, asociando con distinto pronóstico (Rozman y cols., 1984).Al contrario que en otros síndromes linfoproliferativos, no existe una alteración genómica responsable del desencadenamiento de la enfermedad.Sin embargo, la mayoría de los pacientes de LLC presentan mutaciones en sugenoma, incluyendo del 13q, del 11q, Trisomía del 12 y /o del 17p13, que es capaz de influir el manejo clínico de los enfermos y la respuesta a tratamientos.La enfermedad se detecta en la mayoría de los casos por un incremento en la carga linfocitaria en sangre periférica, sin otros síntomas relevantes. Sin embargo, la evolución de los pacientes es extremadamente heterogénea,existiendo pacientes que nunca requieren tratamiento, otros que precisan ser tratados en distintos momentos de la enfermedad y un grupo con peor pronóstico que desarrolla anemia, trombocitopenia, linfoadenopatías y/o esplenomegalia y presentan una reducida esperanza de vida...
Chronic lymphocytic leukemia (CLL) is the most common leukemia inadults in western countries. It is characterized by the accumulation of leukemiacells in peripheral blood (PB) and bone marrow (BM) and, to a varying extent,lymph nodes (LN) and spleen (SP) (Moreno and Montserrat 2008). CLL cellscharacteristically express CD5, a T-cell related antigen, along with CD19 andCD23 antigens and low levels of CD20 but lack expression of CD10 in contrastto mantle cell lymphomas. In addition, these cells express low levels of surfaceimmunoglobulins, usually IgM and/or IgD. Bone marrow (BM) infiltration occursin all patients at diagnosis and in most cases represents > 30% of the cellularity(Hallek, Cheson et al. 2008). The pattern of infiltration can be nodal, interstitial,diffuse or a mixed one which can be associated with different prognosis(Rozman, Montserrat et al. 1984).In contrast to other lymphoproliferative disorders, there is not a CLLspecificgenomic aberration responsible of its development. However, mostpatients present genomic aberrations in the CLL cells, including but not limitedto del13q, del11q, Trisomy 12 and/or del17p13, which influence clinicalmanagement and drug response. The disease is usually detected as anincreased lymphocyte count in PB without further symptoms. However, theclinical course of CLL patients is extremely heterogeneous from patients whonever require treatment, some that has to be treated at different time pointsafter diagnosis and the worst prognosis group that develop anemia,thrombocytopenia, bulky lymphadenopathies and/or splenomegaly at short timesince diagnosis and reduced life expectancy...
Chronic lymphocytic leukemia (CLL) is the most common leukemia inadults in western countries. It is characterized by the accumulation of leukemiacells in peripheral blood (PB) and bone marrow (BM) and, to a varying extent,lymph nodes (LN) and spleen (SP) (Moreno and Montserrat 2008). CLL cellscharacteristically express CD5, a T-cell related antigen, along with CD19 andCD23 antigens and low levels of CD20 but lack expression of CD10 in contrastto mantle cell lymphomas. In addition, these cells express low levels of surfaceimmunoglobulins, usually IgM and/or IgD. Bone marrow (BM) infiltration occursin all patients at diagnosis and in most cases represents > 30% of the cellularity(Hallek, Cheson et al. 2008). The pattern of infiltration can be nodal, interstitial,diffuse or a mixed one which can be associated with different prognosis(Rozman, Montserrat et al. 1984).In contrast to other lymphoproliferative disorders, there is not a CLLspecificgenomic aberration responsible of its development. However, mostpatients present genomic aberrations in the CLL cells, including but not limitedto del13q, del11q, Trisomy 12 and/or del17p13, which influence clinicalmanagement and drug response. The disease is usually detected as anincreased lymphocyte count in PB without further symptoms. However, theclinical course of CLL patients is extremely heterogeneous from patients whonever require treatment, some that has to be treated at different time pointsafter diagnosis and the worst prognosis group that develop anemia,thrombocytopenia, bulky lymphadenopathies and/or splenomegaly at short timesince diagnosis and reduced life expectancy...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Ciencias Biológicas, leída el 3-07-2017