Tumor cells in chronic lymphocytic leukemia or small lymphoblastic lymphoma (CLL/SLL) arisefrom which of the following?
Mature B cell
Naive B cell
Centrocytes of germinal center
Progenitor B-cell
DNA sequencing has revealed that the Ig genes of some CLL/SLL are somatically hypermutated whereas others are not, suggesting that the cell of origin may be either a post germinal center memory B cell or a naive B cell. For unclear reasons, tumors with unmutated Ig segments (those putatively of naive B-cell origin) pursue a more aggressive course. Impoant points about CLL: CLL is the most common leukemia of adults in the Western world. CLL is the cancer which is associated with presence of Autoimmune Hemolytic Anemia. CLL is the cancer which is not associated with Radiation exposure. CLL patient blood sample contains large numbers of small round lymphocytes with scant cytoplasm. Some of these cells are usually disrupted in the process of making smears, producing so-called Smudge cells. These patients are best identified with the help of Tumor cells exhibiting specific type of CD markers paicularly -CD19, CD20, CD23, CD5.