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Patterns of CLL Growth Identified

Published: 2019-06-01 |

Source: Dana-Farber Cancer Institute

In patients with chronic lymphocytic leukemia (CLL), the rate of disease growth is apt to follow one of three trajectories: relentlessly upward, steadily level, or something in between, scientists at Dana-Farber Cancer Institute, the Board Institute of MIT and Harvard, Massachusetts General Hospital, and the University of Washington report in a new study. The particular course of the disease takes is tightly linked to the genetic make-up of the cancer cells, particularly the number of growth-spurring "driver" mutations they contain.

The study published on-line today by the journal Nature, contains a further insight: genetic changes that occur very early in CLL development exert a powerful influence on the growth pattern the CLL cells will ultimately take. This raises the possibility that physicians may one day be able to predict the course of the disease by its molecular features at the time of the diagnosis.

"Our findings provide a framework not only for understanding the differing patterns of CLL growth in patients but also for exploring the basic biological mechanisms that underlie these differences," said Catherine J, Wu, of Dana-Farber, the Board Institute, and Brigham and Women's Hospital, the co-senior author of the study with Gad Getz, PhD, of the Board Institute and Massachusetts General Hospital. "Ultimately, we'd like to be able to tie the genotype of the disease--the particular genetic abnormalities in a patient's cancer cells--to the phenotype, or how the cancer actually behaves," Getz remarked.

CLL is a useful model for studying the pace of cancer growth because it progresses at widely different rates from one patient to another, Wu explained. In many patients, it persists at a very low level for many years before advancing to the point where treatment is necessary. In others, it progresses so rapidly that treatment is required shortly after diagnosis.

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