ABSTRACT
This chapter reviews the cellular and molecular biology of the chronic lymphoid leukaemias and how they impact the diagnosis, prognosis and treatment. Lymphoid leukaemias of mature B- and T- and, in very rare instances, Natural killer (NK)-cells are chronic lymphoproliferative disorders characterized by the accumulation and proliferation of clonal lymphocytes; of the corresponding lineage in the blood, bone marrow, lymph nodes and sometimes other lymphoid tissues. A critical denominator for success following an allogeneic stem cell transplantation is the graft-versus-leukaemia (GvL) effect, which is primarily T-cell mediated. In efforts to reduce the transplant-related morbidity and mortality, reduced intensity allografts, which can exploit GvL, have been increasingly utilized. A role of human T-cell lymphotropic virus has been suggested for all subtypes of large granular lymphocyte (LGL) leukaemias. For patients with the LGL leukaemias, much work is needed to develop therapies which can afford durable remissions, in particular for those with aggressive subtypes.
