Video Information: What is going on in the body of a person with chronic lymphocytic leukemia (CLL)? Increase your understanding of the condition as CLL experts Dr. Michael Keating and Dr. Kathryn Kolibaba break down the basics of the disease.
So the idea is we have targeted therapy, and you knock back the cancer. Now, just to be clear: Dr. Keating, you explained this to me like, however many, 21 years ago. When we develop CLL, we’re developing immature or defective B cells. That’s what it is, right?
Yes. The normal role of B cells is to make an antibody to protect us against viral infections, bacterial etc. So we’ve been exposed to these over a long period of time, and eventually they become memory B cells, or plasma cells, and they continue to churn out antibody at a low level and can be re-stimulated again.
And the CLL cells almost always, perhaps about 95 percent of the time, can’t make an antibody. They don’t deliver an antibody. You can detect it if you work really hard to find out what antibody they should be making, but they don’t make an antibody, and they tend to suppress the other B cells from making the good antibodies that they are supposed to be making. So not only do they make—not be able to make anything, but they stop their neighbors from being able to function well.
Now, I want to get a shot over here. Guys, anybody have a bone marrow biopsy? Raise your hand, I’ve had a few. Some of you—they don’t do them—some of you don’t always have to do it so much. So I had it before I saw Dr. Keating 21 years ago, had to stick the needle in there. Fortunately, I’ve never seen the needle, because I know it’s a big one. And you would look at how impacted the bone marrow is with churning out these B cells, right?
And if I get it right, and Dr. Kolibaba, correct me if I’m wrong—the concern is not just that you’re making these defective cells, but does it affect other cell production, right?
Because that’s your bone—that’s your blood factory, right?
Right, and that’s one of the reasons we sometimes have to treat is because the CLL is—is preventing the bone marrow from making platelets, or normal white cells, or normal red cells. So definitely, it can fill up the bone marrow. And I actually have found that sometimes people are more frightened by seeing that wonderful—to me—picture of that bone marrow full of CLL than they were of having large nodes or a large spleen. But our treatments are very effective.