Pathogenesis of intractable chronic lymphocytic leukemia (ICLL).
About 23% of all patients with chronic lymphocytic leukemia (CLL) are resistant to chemotherapy and have intractable CLL. Recent work showed the usefulness of splenectomy for the treatment of ICLL patients. The peripheral blood lymphocytes of ICLL patients were radioresistant in vitro. This reaction provided a diagnostic test for ICLL. Normal lymphocytes are highly radiosensitive but become radioresistant on the addition of phytohemagglutinin or other mitogens. These findings suggest the hypotheses: ICLL arises from splenic lymphocytes which have reacted to an immune stimulus; ICLL is a discrete disease with its own pathogenesis, diagnosis and therapy.