Blanco, Gonzalo, Morris, Edward, Morris, Jodie L., Letson, Hayley L., Susheel, Suvarna, Puiggros, Anna, Espinet, Blanca, Chiorazzi, Nicholas, and Dobson, Geoffrey P. (2024) Spontaneous Regression Accompanied by Concomitant Immune Alterations in a Patient with Chronic Lymphocytic Leukemia. Annals of Case Reports, 9. 101539.

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Abstract

Spontaneous regression (SR) of chronic lymphocytic leukemia (CLL) is a rare event (0.2% - 1%). Some advances have been made in understanding the tumor genetic characteristics of such patients, although the immunological mechanisms leading to SR remain unclear. We describe a series of immunological events related to regression dynamics, allowing the identification of a SR phase (associated with >99% reduction of CLL cells in peripheral blood and adenopathy resolution in less than one year, concurrently with a nine-fold increase in monocyte counts, high B2M and the appearance of an oligoclonal serum IgG band), followed by a persistent regression (PR) phase that was maintained for ≥17 months. Our observations highlight a role of monocytes and B2M in SR, potentially related to immune activation. The oligoclonal IgG band detected during SR was maintained in PR, suggesting either a change in the ability of malignant cells (IgM+IgD+IgG‒) to differentiate into IgG-secreting cells, or an anti-tumor humoral response from normal B cells. These findings imply immune and molecular mechanisms required to eliminate malignant cells and might suggest new immunotherapies for CLL.

Item ID:	82416
Item Type:	Article (Other)
ISSN:	2574-7754
Keywords:	Spontaneous Regression (SR); Persistent Regression (PR); Monocytes; β-2 Microglobulin (B2M); Immunoglobulin G (IgG)
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Copyright Information:	© 2024 by the Authors & Gavin Publishers. This is an Open Access Journal Article Published Under Attribution-Share Alike CC BY-SA: Creative Commons Attribution-Share Alike 4.0 International License. With this license, readers can share, distribute, download, even commercially, as long as the original source is properly cited.
Date Deposited:	14 May 2024 01:33
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3211 Oncology and carcinogenesis > 321106 Haematological tumours @ 90% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3211 Oncology and carcinogenesis > 321109 Predictive and prognostic markers @ 10%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200101 Diagnosis of human diseases and conditions @ 100%
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