CLL Coverage from Every Angle

Does Overexpression of Altered Follicular Helper T Cells Promote Proliferation of CLL?

By: Kayci Reyer
Posted: Wednesday, June 30, 2021

Research presented in Frontiers in Oncology suggests there may be an association between abnormal follicular helper T-cell abundance and the development of chronic lymphocytic leukemia (CLL). Aaron J. Marshall, PhD, of the University of Manitoba, Canada, and colleagues found that elevated cytokines and co-stimulatory molecules produced by these abnormal cells may spur disease proliferation.

The study assessed peripheral blood and bone marrow aspirates from patients with CLL who were seen at the CancerCare Manitoba clinic. Elevated levels and phenotypically abnormal expressions of follicular helper T cells were observed, including increased levels of PD-1, TIGIT, CD40L, IFN𝛾, and IL-21 and abnormal expression of follicular helper subsets 1, 2, and 17. The leukemia B-cell clone was suggested to accompany the rate of abnormal follicular helper T-cell creation due to the positive correlation noted between patient RAI stage and lymphocyte count and the occurrence of CD4-positive T cells with markers for subset 1 and IL-21.

Multiple functional markers had higher expression rates in follicular helper cells found in the bone marrow versus those found in the blood. An association was noted between the frequencies of follicular helper T cells and the ability of CD4-positive T cells to support disease progression. Ibrutinib treatment resulted in follicular helper T cell frequency and phenotypic normalization.

“These results define alterations in [follicular helper T cell] phenotype and function in CLL and indicate a potential role for these cells as part of the dysfunctional immune microenvironment in this disease,” concluded the study authors.

Disclosure: For full disclosures of the study authors, visit

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