Chronic lymphocytic leukemic cells are characterized by an apparent longevity in vivo which is lost when they are cultured in vitro. This observation suggests that cellular interactions and factors provided by the microenvironment are essential to cell survival and may protect leukemic cells from the cytotoxicity of conventional therapies. Moreover the infiltration of CLL cells in lymphoid tissue and in bone marrow is a key element in disease pathogenesis and correlates with clinical stage. Increasing emphasis is now placed on understanding the leukemic/stromal cells cross-talk to identify signals supporting disease progression and to explore novel therapies targeting the microenvironment. This review will focus on critical cellular and molecular pathways of CLL-microenvironment interactions: in vitro and in vivo models for studying the CLL microenvironment will be discussed and new strategies that are being evaluated to disrupt protective signals that support expansion of the neoplastic B cell clone will be described.
Total Pages: 3-41 (39)
Download Free Book Details