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Medicina
Special Issues
Chronic Lymphocytic Leukemia: New Insights and Future Directions
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Chronic Lymphocytic Leukemia: New Insights and Future Directions

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (29 November 2023) | Viewed by 2141

Special Issue Editor

Dr. Mohamed Gadelkarim

E-Mail Website
Guest Editor
Immunomodulation and Translational Cancer Research Program, Department of Surgery, School of Medicine, University of Missouri NextGen Precision Health Bldg., 1030 Hitt Street, Columbia, MO 65211, USA
Interests: chronic lymphocytic leukemia; cancer biology; immunology; epidemiology

Special Issue Information

Dear Colleagues,

Chronic lymphocytic leukemia (CLL) is the most common leukemia in Western countries, with less prevalence in Asia and being relatively rare in Japan and Korea. It affects more men than women, and the median age of diagnosis is 67–72 years. It is classified as a malignancy of CD5+ B cells, characterized by the accumulation of small-in-size, mature-appearing lymphocytes in the blood, lymphoid tissues, and bone marrow.

The prognosis for CLL mainly depends on the presence or absence of specific genetic aberrations, which include del(11q), del(17p), TP53 dysfunction, and immunoglobulin heavy-chain gene mutations, as these mutations are associated with less favorable prognoses and treatment responses. Recently, published evidence elucidated targeting B-cell leukemia/lymphoma 2, Bruton’s tyrosine kinase, and phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit delta, all which are considered promising and reliable targets for CLL treatment. However, these shreds of evidence elucidating favorable outcomes and prolonged progression-free survival in patients treated with these therapies are insufficient to reach robust conclusions and guidelines for treatment.

In this context, we aim to explore the epidemiology, microenvironment, gene mutations, and promising treatment targets for CLL in this Special Issue. The scope of the Special Issue is deliberately kept broad, which would allow coverage of a wide range of perspectives and different topics related to CLL pathogenesis and management, with particular emphasis on new insights and future directions.

Dr. Mohamed Gadelkarim
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • lymphoid neoplasia
  • chronic lymphocytic leukemia
  • CLL
  • epidemiology
  • microenvironment
  • genomic profiling
  • management
  • immunotherapy

Published Papers (1 paper)

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Research

15 pages, 1384 KiB  
Article
A Nine-Gene Expression Signature Distinguished a Patient with Chronic Lymphocytic Leukemia Who Underwent Prolonged Periodic Fasting
by Luca Emanuele Bossi, Cassandra Palumbo, Alessandra Trojani, Agostina Melluso, Barbara Di Camillo, Alessandro Beghini, Luca Maria Sarnataro and Roberto Cairoli
Medicina 2023, 59(8), 1405; https://doi.org/10.3390/medicina59081405 - 31 Jul 2023
Viewed by 1619
Abstract
Background and Objectives: This study aimed to investigate the causes of continuous deep fluctuations in the absolute lymphocyte count (ALC) in an untreated patient with Chronic Lymphocytic Leukemia (CLL), who has had a favorable prognosis since the time of diagnosis. Up until [...] Read more.
Background and Objectives: This study aimed to investigate the causes of continuous deep fluctuations in the absolute lymphocyte count (ALC) in an untreated patient with Chronic Lymphocytic Leukemia (CLL), who has had a favorable prognosis since the time of diagnosis. Up until now, the patient has voluntarily chosen to adopt a predominantly vegetarian and fruitarian diet, along with prolonged periods of total fasting (ranging from 4 to 39 days) each year. Materials and Methods: For this purpose, we decided to analyze the whole transcriptome profiling of peripheral blood (PB) CD19+ cells from the patient (#1) at different time-points vs. the same cells of five other untreated CLL patients who followed a varied diet. Consequently, the CLL patients were categorized as follows: the 1st group comprised patient #1 at 20 different time-points (16 time-points during nutrition and 4 time-points during fasting), whereas the 2nd group included only one time point for each of the patients (#2, #3, #4, #5, and #6) as they followed a varied diet. We performed microarray experiments using a powerful tool, the Affymetrix Human Clariom™ D Pico Assay, to generate high-fidelity biomarker signatures. Statistical analysis was employed to identify differentially expressed genes and to perform sample clustering. Results: The lymphocytosis trend in patient #1 showed recurring fluctuations since the time of diagnosis. Interestingly, we observed that approximately 4–6 weeks after the conclusion of fasting periods, the absolute lymphocyte count was reduced by about half. The gene expression profiling analysis revealed that nine genes were statistically differently expressed between the 1st group and the 2nd group. Specifically, IGLC3, RPS26, CHPT1, and PCDH9 were under expressed in the 1st group compared to the 2nd group of CLL patients. Conversely, IGHV3-43, IGKV3D-20, PLEKHA1, CYBB, and GABRB2 were over-expressed in the 1st group when compared to the 2nd group of CLL patients. Furthermore, clustering analysis validated that all the samples from patient #1 clustered together, showing clear separation from the samples of the other CLL patients. Conclusions: This study unveiled a small gene expression signature consisting of nine genes that distinguished an untreated CLL patient who followed prolonged periods of total fasting, maintaining a gradual growth trend of lymphocytosis, compared to five untreated CLL patients with a varied diet. Future investigations focusing on patient #1 could potentially shed light on the role of prolonged periodic fasting and the implication of this specific gene signature in sustaining the lymphocytosis trend and the favorable course of the disease. Full article
(This article belongs to the Special Issue Chronic Lymphocytic Leukemia: New Insights and Future Directions)
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