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Chronic lymphocytic leukemia (CLL) is a type of cancer that affects the blood and bone marrow. [8] [9] In CLL, the bone marrow makes too many lymphocytes, which are a type of white blood cell.
B-cell CLL/lymphoma refers to a family of genes associated with certain types of lymphoma and leukemia. Although named for B-cell chronic lymphocytic leukemia, they can be associated with other malignancies. Members include: CCND1 (also known as "BCL1") BCL2; BCL3; BCL5; BCL6, BCL6B; BCL7A, BCL7B, BCL7C; BCL8; BCL9; BCL10; BCL11A, BCL11B
Genetic variations in BCL3 gene have been associated with late-onset Alzheimer's disease (LOAD) and chronic lymphocytic leukemia. β-amyloid accumulation in neurons of Alzheimer's patients results in activation of NF-κB, which induces BCL3 expression. [16] Increased expression of BCL3 has been observed in the brains of patients with LOAD. [17]
Treatment may involve some combination of chemotherapy, radiation therapy, targeted therapy, and bone marrow transplant, with supportive and palliative care provided as needed. [3] [6] Certain types of leukemia may be managed with watchful waiting. [3] The success of treatment depends on the type of leukemia and the age of the person.
Additional treatments such as Chimeric antigen receptor T cell immunotherapy are being used and further studied. [2] Acute lymphoblastic leukemia affected about 876,000 people globally in 2015 and resulted in about 111,000 deaths. [14] [10] It occurs most commonly in children, particularly those between the ages of two and five.
Venetoclax is also indicated as part of a combination therapy for acute myeloid leukemia (AML). [7] For this purpose it is used with azacitidine, decitabine, or low-dose cytarabine for newly diagnosed adults who are age 75 years or older, or those with other health problems where intensive chemotherapy cannot be used.
In July 2014, the FDA granted breakthrough therapy status to blinatumomab for the treatment of acute lymphoblastic leukemia (ALL). [12] In October 2014, Amgen's Biologics License Application for blinatumomab was granted priority review designation by the FDA , thus establishing a deadline of 19 May 2015, for completion of the FDA review process.
The most common secondary neoplasm is secondary acute myeloid leukemia, which develops primarily after treatment with alkylating agents or topoisomerase inhibitors. [109] Survivors of childhood cancer are more than 13 times as likely to get a secondary neoplasm during the 30 years after treatment than the general population. [ 110 ]
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