Wierda: This is a case study of a year-old male incidentally noted to have lymphocytosis on a routine CBC. ZAP70 expression was positive. Fluorescence in situ hybridization FISH was done at diagnosis, which is not required but in this case it was done. And this patient had trisomy 12 and del 17p and had an unmutated IGHV gene.
Case Study: Rare Richter Transformation of CLL Involving the Ear
Chronic lymphocytic leukemia: case-based session
June 17, , by NCI Staff. Additional coverage: A new study shows that combining venetoclax Venclexta with ibrutinib Imbruvica may be an effective initial treatment for CLL. The combination of venetoclax and obinutuzumab is given in 12 four-week cycles. Patients receiving this drug take it until the disease progresses or the side effects become unmanageable. In CLL, the bone marrow makes too many lymphocytes a type of white blood cell ; in SLL, the lymph nodes produce too many lymphocytes. Venetoclax, a pill, blocks the action of a protein called BCL2, which helps to keep cancer cells alive. Obinutuzumab, a monoclonal antibody that is injected intravenously, targets a protein called CD20 , which is frequently found on the surface of tumor cells in patients with certain types of leukemias.
Chronic Lymphocytic Leukemia Treatment (PDQ®)–Patient Version
Characteristics of patients with chronic lymphocytic leukemia can mask COVID infection, creating a risk for patients, practitioners, and the community, according to a case study published in the Lancet Haematology. A year-old man with a history of non-Hodgkin lymphoma and chronic lymphocytic leukemia CLL presented at a clinic in Wenzhou, China, with symptoms of fever, sore throat, productive cough, and dyspnea, according to the authors. COVID infection was not initially suspected, as his whole blood cell and lymphocyte counts were high, the CLL masked a potential infection, and the patient claimed he had no suspect recent travel history. Testing was ordered and the real-time reverse-transcription polymerase chain reaction assay result was positive. The patient was immediately transferred to the isolation ward for management and confirmed COVID infection.
The doctors who have spent years studying the case call it "a series of fortunate events. Researchers at the University of Pennsylvania's Abramson Cancer Center say a patient treated for chronic lymphocytic leukemia CLL in went into remission because of a single CAR T cell and the cells it produced as it multiplied, and has stayed cancer free in the five years since, with CAR T cells still present in his immune system. The findings, published today in Nature , show the response is tied to where the CAR gene inserted itself into the patient's T cell DNA, a key factor that may help improve response rates to the therapy. CLL is a type of cancer that starts in cells that become certain white blood cells in the bone marrow , and then move into the blood and lymph nodes. These cancer cells reproduce too quickly and crowd out other cells in the bone marrow.