Department of Cellular Pathology, University College Hospital London, London, UK.
Br J Haematol. 2013 Jul;162(1):15-24. doi: 10.1111/bjh.12344. Epub 2013 Apr 25.
Chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL) is one of the more common forms of B cell malignancy. Although the condition has a variable clinical course, the trend is towards eventual relapse and the disease is considered incurable. Whilst the majority of the circulating CD5-positive neoplastic B cells are arrested in the G0 phase of the cell cycle, those in the bone marrow and lymphoid tissues proliferate at a rate of 0·1-1% of the entire clone per day. This proliferation is supported by the tissue microenvironment, which has been shown to induce upregulation of anti-apoptotic proteins and enhance the survival of the neoplastic cells. Microenvironmental factors are also thought to be important in tumour relapse and resistance to therapy. This review outlines the main signalling pathways involved in these tumour cell-stromal interactions, and includes potential therapeutic strategies based on the manipulation of key components within the CLL microenvironment.
慢性淋巴细胞白血病/小淋巴细胞淋巴瘤（CLL）是 B 细胞恶性肿瘤中较为常见的一种。尽管该疾病的临床病程存在差异，但疾病最终会复发，且被认为是不可治愈的。虽然循环中的大多数 CD5 阳性肿瘤 B 细胞处于细胞周期的 G0 期停滞，但骨髓和淋巴组织中的细胞每天以整个克隆的 0.1-1%的速度增殖。这种增殖受到组织微环境的支持，已证明组织微环境会诱导抗凋亡蛋白的上调，并增强肿瘤细胞的存活。微环境因素也被认为在肿瘤复发和对治疗的耐药性中起着重要作用。本综述概述了这些肿瘤细胞-基质相互作用中涉及的主要信号通路，并包括基于 CLL 微环境中关键成分的操纵的潜在治疗策略。
