Division of Medical Oncology, Duke University Medical Center, Durham NC 27710, USA.
Hematology Am Soc Hematol Educ Program. 2010;2010:70-6. doi: 10.1182/asheducation-2010.1.70.
Significant advancements in the care of patients with chronic lymphocytic leukemia (CLL) have occurred over the past decade. Nonetheless, CLL remains incurable outside of allogeneic transplantation. CLL is the most common leukemia in the United States and Europe, and new treatments and therapeutic strategies are clearly needed. To address this need, the pathogenesis of CLL has been an area of intense ongoing investigation. These international efforts illuminate a complex biology that is reliant on the interplay of inherited, environmental, and host factors. This broad review will discuss the recent advances in our understanding of CLL biology including the elucidation of inherited and acquired genetic changes; the role of the B-cell receptor and B-cell receptor signaling; CLL cell kinetics; and the interactions in the microenvironment between CLL cells, other immune cells, and stromal elements. This improved understanding of disease pathogenesis is facilitating the development of novel therapeutic treatment strategies.
过去十年中，慢性淋巴细胞白血病 (CLL) 患者的治疗取得了重大进展。尽管如此，除了异基因移植之外，CLL 仍然无法治愈。CLL 是美国和欧洲最常见的白血病，显然需要新的治疗方法和治疗策略。为了满足这一需求，CLL 的发病机制一直是正在进行的深入研究领域。这些国际努力揭示了一种复杂的生物学，它依赖于遗传、环境和宿主因素的相互作用。本综述将讨论我们对 CLL 生物学理解的最新进展，包括阐明遗传和获得性遗传变化；B 细胞受体和 B 细胞受体信号的作用；CLL 细胞动力学；以及 CLL 细胞、其他免疫细胞和基质成分之间在微环境中的相互作用。对疾病发病机制的这种深入了解正在促进新型治疗策略的发展。
