Emili Montserrat, M.D. Hospital Clinic Barcelona (Spain)

TRANSPLANTATION/IMMUNE RECONSTITUTION

Modern therapy and immune function in patients with chronic lymphocytic leukemia (CLL). A multiparametric approach

Grant Awarded in 2008

Abstract:

CLL is characterized by the accumulation of monoclonal CD5+ B-lymphocytes and important immune abnormalities that are poorly studied if not totally neglected in CLL investigation. In particular, it is not known whether immune status influences response to therapy and whether immune function is ever recovered in CLL patients responding to therapy.

We hypothesize that immune function can alter response to therapy and its quality (e.g. MRD negativity achievement) in patients with CLL. Also, immune function might determine treatment outcome, as shown by the relationship between the graft-vs. CLL effect and treatment results in CLL patients having received an allograft.

Against this background, we plan to perform a multiparametric study and comparison of the immune status in patients with CLL: (1) untreated; (2) immediately prior to therapy; (3) after achieving response to (3a) chemo/chemo-immunotherapy, (3b) autologous stem cell transplantation, and (3c) allogeneic stem cell transplantation.

Immune function will be studied by both quantitative and functional parameters including: serum markers, B- and T-cell populations, T-regulatory cells, BAFF, APRIL. TK, VEGF, beta-2 microglobulin

A preliminary analysis of the study should allow us to fully describe immune status in patients with CLL in different clinical situations, particularly untreated and treated, and to identify parameters deserving further and more in depth investigation. In addition, throughout the study period, cells and serum samples will be frozen and preserved in order to refine the study as well as to study new, additional factors if deemed necessary.

Finally, patients' samples will be made available to other USA/European Alliance institutions for other or additional investigations.