Medically reviewed by Dr. Brian Koffman
While chronic lymphocytic leukemia (CLL) is a cancer of the B cells, it can affect the whole immune system. Patients with CLL and small lymphocytic lymphoma (SLL) are immunocompromised, meaning that their immune system doesn’t function as well as a healthy person’s. This leads to a reduced ability to fight off infections and other diseases. In this interview, Dr. Brian Koffman spoke with Dr. Arnon Kater, a professor of hematology at Amsterdam University Medical Center. They discussed how CLL / SLL affects the immune system.
What are B cells and T cells?
“Everyone has white blood cells, which are like your body’s army that fights off foreign invaders (viruses, bacteria, parasites, etc.). They can also recognize and destroy abnormal cells like cancer cells. Some types of white blood cells are specialized cells that are responsible for creating your immune system’s memory. For instance, when you get a vaccination, your immune cells remember it and then fight off the corresponding pathogen when you are exposed to it in the real world.
There are memory B cells and T cells, which are responsible for remembering intruders and then mounting immune responses if that intruder is encountered again. B cells produce antibodies, which bind to pathogens and mark them for destruction. T cells directly bind to cells infected with pathogens and inject toxins to kill them.”
How does CLL affect the immune system?
“CLL / SLL is a cancer of the B cells, so when B cells are dysfunctional, it impairs the immune system’s memory and ability to produce antibodies. CLL can also affect other parts of the immune system, especially when there is a lot of it in the blood and bone marrow.”
Usually, B and T cells work together to mount an immune response to pathogens. However, CLL can also cause T cells to become “exhausted, meaning that they are dysfunctional and impair their ability to proliferate, kill pathogens, and signal to other immune cells. Currently, it is not entirely clear how CLL cells cause these effects on T cells, but Dr. Kater and other researchers are studying this issue.
What is the role of metabolism in T cell function?
“One emerging area of cancer research is the role of metabolism in cells. Every cell has its own metabolism and needs different fuels at different stages. T cells cruising around the body, such as memory T cells, use a type of metabolism called oxidative phosphorylation, which is efficient but not very powerful, similar to a hybrid car using an electric battery. However, when T cells need to kill pathogens, they switch to a different type of metabolism called glycolysis, which is more powerful, similar to using gas in a hybrid car to get more power. Researchers are investigating whether altering T cell metabolism can improve their function.”
Links and Resources:
Watch the interview with Dr. Arnon Kater:
Take care of yourself first.
Ann Liu, PhD
