In lymphoproliferative neoplasms including chronic lymphocytic leukemia (CLL), hairy cell leukemia and even multiple myeloma, the biology of the monoclonal cells as well as the surrounding cells which are called microenvironment of the bone marrow are known to be in an interplay. Data of 275 patients diagnosed with B-CLL were collected in a retrospective manner. Demographic features, laboratory including flow cytometry, immunoglobulins, genetic evaluations and clinical follow up were recorded from files. 111 patients were female (40.4%) while 164 were male (59.6%). Mean age was 70.46 years (21-92). CD8 positivity on CLL cells was observed in 12 patients. No significance was observed regarding complications and survival. 71 patients demonstrated a dense surrounding CD8 positive lymphocytes. Of the se patients, none had 17p deletion while 28 patients demonstrated 13q deletion (39.4% of CD8+ Treg group while 82.3% of all patients with 13q del) and 6 patients had 11q deletion. ITP, lowIgG levels, development of second ary malignancies, high percentage of bone marrow infiltration, Richter’s transformation were significantly corelated. CD8+ T lymphocyte richness in the microenvironment was significantly related with survival. Cancer is related with immunodefiency. With the evolution of tumors, they find ways to elude immune recognition. CD8 expression on B-CLL cells may not be explained with clinical features or prognosis. But the density of CD8 within the infiltrated bone marrow may explain the long term immune escape of CLL cells, with the effort to balance immune regulation by disease control, though resulting with increased autoimmunity.
___
Swann JB, Smyth MJ. Immune surveillance of tumors. J Clin Invest 2007; 117: 1137-1146.
Bhardwaj N. Harnessing the immune system to treat cancer. J Clin Invest 2007; 117: 1130-1136.
Ramsay AG, Johnson AJ, Lee AM, et al. Chronic lymphocytic leukemia T cells show impaired immunological synapse formation that can be reversed with an immunomodulating drug. J Clin Invest 2008; 118: 2427-2437.
Moreira J, Rabe KG, Cerhan JR. Infectious complications among individuals with clinical monoclonal B-cell lymphocytosis (MBL): a cohort study of newly diagnosed cases compared to controls, Leukemia 2013; 27: 136-141.
Rossi D, Sozzi E, Puma A, De Paoli L. The prognosis of clinical monoclonal B lymphocytosis differs from prognosis of Rai 0 chronic lymphocytic leukemia and is recapitulated by biological risk factors Br J Haematol 2009; 146 64-75.
Forconi F, Moss P. Perturbation of the normal immune system in patients with CLL Blood 2015; 126: 573-581.
Gershon RK, Kondo K. Cell interactions in the induction of tolerance: the role of thymic lymphocytes. Immunology 1970; 18: 723-737.
Takeuchi Y, Nishikawa H. Roles of regulatory T cells in cancer immunity. Int Immunol 2016; 28: 401-409.
Lad DP, Varma S, Varma N. Regulatory T-cells in B-cell chronic lymphocytic leukemia: their role in disease progression and autoimmune cytopenis Leukemia and Lymphoma 2013; 54: 1012-1019.
D’Arena G, Simeon V, D’Auria F. Regulatory Tcells in chronic lymphocytic leukemia: actor or an innocent bystander? Am J Blood Res 2013; 3: 52-57.
D'Arena G, Vitale C, Coscia M, et al. Regulatory T Cells and Their Prognostic Relevance in Hematologic Malignancies. J Immunol Res 2017; 2017: 1832968.
Mpakou VE, Ioannidou HK, Konsta E. Quantitative and qualitative analysis of regulatory T cells in b cell chronic lymphocytic leukemia Leuk Res 2017; 60: 74-81.
Deepesh L, Hoeppli R, Huang Q. Regulatory T cells drive immune dysfunction in CLL Leuk&Lymph 2018; 59: 486-489.
Huergo-Zapico L, Acebes-Huerta A, GonzalezRodriguez AP, et al. Expansion of NK cells and reduction of NKG2D expression in chronic lymphocytic leukemia. Correlation with progressive disease. PLoS One 2014; 9: 108326.
te Raa GD, Tonino SH, Remmerswaal EB, et al. Chronic lymphocytic leukemia specific T-cell subset alterations are clone-size dependent and not present in monoclonal B lymphocytosis. Leuk Lymphoma 2012; 53: 2321-2325.
Kern W, Bacher U, Haferlach C, et al. Frequency and prognostic impact of the aberrant CD8 expression in 5523 patients with chronic lymphocytic leukemia. Cytometry B Clin Cytom 2012; 82: 145-150.
Umit EG, Baysal M, Durmus Y, Demir AM. CD11c expression in chronic lymphocytic leukemia revisited, related with complications and survival Int J Lab Hematol 2017; 39: 552-556.