Spontaneous Regression Accompanied by Concomitant Immune Alterations in a Patient with Chronic Lymphocytic Leukemia

Journal Contribution ResearchOnline@JCU
Blanco, Gonzalo;Morris, Edward;Morris, Jodie L.;Letson, Hayley L.;Susheel, Suvarna;Puiggros, Anna;Espinet, Blanca;Chiorazzi, Nicholas;Dobson, Geoffrey P.
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.

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Annals of Case Reports

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9

ISBN/ISSN

2574-7754

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Pages Count

6

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Publisher

Gavin Publishers

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DOI

10.29011/2574-7754.101539