Foon K A, Rai K R, Gale R P
Roswell Park Cancer Institute, New York.
Ann Intern Med. 1990 Oct 1;113(7):525-39. doi: 10.7326/0003-4819-113-7-525.
To review the recent advances in the biologic and clinical research of chronic lymphocytic leukemia.
English-language literature search using MEDLINE (1980 to 1990) and CANCERLIT (1980 to 1990), review of meeting abstracts and reports, and an extensive manual search of bibliographies of identified articles.
Approximately 800 articles, abstracts, and book chapters were selected for analysis.
The literature was reviewed and 227 articles were selected as representative of the important advances in chronic lymphocytic leukemia.
Chronic lymphocytic leukemia is a disease of lymphocytes that appear to be mature but are biologically immature. These B lymphocytes arise from a subset of CD5-B cells that appear to have a role in autoimmunity. The pathogenesis of chronic lymphocytic leukemia is likely a multistep process, initially involving a polyclonal expansion of CD5-B cells followed by transformation of a single cell. Chromosome studies indicate that trisomy 12 is the most common abnormality, followed by 14q+, 13q, and 11q. These abnormalities portend a poor prognosis. Recent progress in the treatment of chronic lymphocytic leukemia involves three new drugs: fludarabine, pentostatin, and 2-chlorodeoxyadenosine. Recent preliminary results of allogeneic bone marrow transplantation present insights into the potential curability of chronic lymphocytic leukemia. Therapy with intravenous immunoglobulin can prevent or delay moderate bacterial infections in persons with chronic lymphocytic leukemia.
Major advances in the biologic research of chronic lymphocytic leukemia have resulted in new understanding of this complex disease. New therapies, such as those with intravenous immunoglobulin and fludarabine, may lead to improved outcome.
综述慢性淋巴细胞白血病生物学及临床研究的最新进展。
利用MEDLINE（1980至1990年）和CANCERLIT（1980至1990年）进行英文文献检索，查阅会议摘要和报告，并对已识别文章的参考文献进行广泛的手工检索。
约800篇文章、摘要和书籍章节被选作分析对象。
对文献进行综述，选取227篇文章作为慢性淋巴细胞白血病重要进展的代表。
慢性淋巴细胞白血病是一种淋巴细胞疾病，这些淋巴细胞看似成熟但生物学上不成熟。这些B淋巴细胞源自CD5 - B细胞亚群，该亚群似乎在自身免疫中起作用。慢性淋巴细胞白血病的发病机制可能是一个多步骤过程，最初涉及CD5 - B细胞的多克隆扩增，随后是单个细胞的转化。染色体研究表明，12号染色体三体是最常见的异常，其次是14q +、13q和11q。这些异常预示着预后不良。慢性淋巴细胞白血病治疗的最新进展涉及三种新药：氟达拉滨、喷司他丁和2 - 氯脱氧腺苷。异基因骨髓移植的近期初步结果为慢性淋巴细胞白血病的潜在治愈提供了见解。静脉注射免疫球蛋白治疗可预防或延缓慢性淋巴细胞白血病患者的中度细菌感染。
慢性淋巴细胞白血病生物学研究的重大进展使人们对这种复杂疾病有了新的认识。新的治疗方法，如静脉注射免疫球蛋白和氟达拉滨治疗，可能会改善治疗结果。
