Re: apoptosis / remission / nodes vs. peripheral blood

[Guest guest]

The rate of production of CLL cells is increased when

proliferation centers are plentiful. Although they can occur

in the bone marrow they are most evident in lymph nodes and

spleen. There are thousands of lymph nodes in the body, so

even if they are very small and not palpable they can be

enough to generate a rapidly increasing ALC. In order to

stay alive CLL cells need to receive growth signals and if

they don't receive them or they are blocked by CAL-101 or

the Btk inhibitor, then they will enter apoptosis. CLL cells

are relatively resistant to apoptosis but they will die.

Karni writes:

This is so confusing. I just don't understand... If CLL

cells are more likely to undergo apoptosis in peripheral

blood, then what is happening when peripheral counts keep

climbing in a patient in whom the nodes or spleen dont seem

to be swelling? What is the relationship between nodes and

the marrow in this regard? The marrow is creating these

cells and sending them into the blood, but they dont pile

up in nodes. I cant say I understood it before this recent

conversation, but I can only continue shaking my head and

feeling totally bewildered.