Tuesday, August 13, 2013

Follicular Lymphoma Microenvironment

Interesting (though very early) research on Follicular Lymphoma's microenvironment from the July issue of the Journal of Clinical Oncology, and an article from British researchers called "Follicular Lymphoma Cells Induce Changes in T-Cell Gene Expression and Function: Potential Impact on Survival and Risk of Transformation."

As the title implies, the article describes how Follicular Lymphoma cells mess with the body's defenses, and furthermore, how looking closely as those messes might (might) tell us something about the likelihood of a patient's survival and/or transformation to an aggressive lymphoma.

The researchers knew (as we all do) that cancer cells do a fantastic job of tricking the body's natural defenses into thinking that everything is OK, allowing the cancer cells to grow unchecked. Normally, an invader or a threatening cell is destroyed by an immune system cell, either a B cell or a T cell. These reserchers looked specifically at a kind of T cell called a TIL (Tumor-Infiltrating T Cell), which is a T cell that leaves the bloodstream (where they hang out an wait) and attaches itself to a tumor. They took TIL samples from biopsies from 172 Follicular Lymphoma patients before they had treatment, and compared them to healthy T cells from 12 people who were lucky enough to not have cancer. They found that the TILs had several genetic changes, compared to the healthy T cells.

Then they went a step further, and exposed the healthy T cells to Follicular Lymphoma cells, and found that the cells changed in the same way. So, clearly, the Follicular Lymphoma cells have something to do with the genetic changes. In addition to messing with their genes (and making them less effective), the healthy cells also had decreased mobility, so they couldn't move to their target as easily as healthy T cells.

One last step:  they looked at how many TILs were present, and where they showed up, and found that that number and location had a serious correlation to overall survival and the chances for transformation.

BUT -- the researchers are very careful to talk about the implications. Right now, there aren't any. It's just too early. The results help us understand just how complex the microenvironment is, and might give us some new clues about what's going on in there. But there will need to be a whole lot more done before we can figure out how this is going to lead to any treatments. For that matter, it will still be a while before we even know how all of this will help predict whether or not a patient will transform.

So, as I said, interesting, but very early research.

I see it as another small piece of a 10,000 piece puzzle being put into place. Once we get the edges done, we can start to work our way in, and at some point, it all comes together.

Until then, patience and hope.

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