Abstract
Chronic lymphocytic leukaemia (CLL) is the most common lymphoid malignancy in Western countries, accounting for around a quarter of all leukaemias. Despite a strong familial basis to CLL, with risks in first-degree relatives of CLL cases being increased around sevenfold, the inherited genetic basis of CLL is currently largely unknown. The failure of genetic studies of CLL families to provide support for a major disease-causing locus has suggested a model of susceptibility based on the co-inheritance of multiple low-risk variants, some of which will be common. Recent genome-wide association studies of CLL have vindicated this model of inherited susceptibility to CLL, identifying common variants at multiple independent loci influencing risk. Here we review the evidence for inherited genetic predisposition to CLL and what the currently identified risk loci are telling us about the biology of CLL development.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Ries LA, Wingo PA, Miller DS, Howe HL, Weir HK, Rosenberg HM, et al. The annual report to the nation on the status of cancer, 1973-1997, with a special section on colorectal cancer. Cancer. 2000;88:2398–424.
Horner MJ, Ries LAG, Krapcho M, Neyman N, Aminou R, Howlader N, et al. (eds). SEER Cancer Statistics Review, 1975-2006, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2006/, based on November 2008 SEER data submission, posted to the SEER web site, 2009.
Gale RP, Cozen W, Goodman MT, Wang FF, Bernstein L. Decreased chronic lymphocytic leukemia incidence in Asians in Los Angeles County. Leuk Res. 2000;24:665–9.
Haenszel W, Kurihara M. Studies of Japanese migrants. I. Mortality from cancer and other diseases among Japanese in the United States. J Natl Cancer Inst. 1968;40:43–68.
Cobb RM, Oestreich KJ, Osipovich OA, Oltz EM. Accessibility control of V(D)J recombination. Adv Immunol. 2006;91:45–109.
Chung JB, Silverman M, Monroe JG. Transitional B cells: step by step towards immune competence. Trends Immunol. 2003;24:343–9.
McHeyzer-Williams LJ, Driver DJ, McHeyzer-Williams MG. Germinal center reaction. Curr Opin Hematol. 2001;8:52–9.
Shapiro-Shelef M, Calame K. Regulation of plasma-cell development. Nat Rev Immunol. 2005;5:230–42.
Fais F, Ghiotto F, Hashimoto S, Sellars B, Valetto A, Allen SL, et al. Chronic lymphocytic leukemia B cells express restricted sets of mutated and unmutated antigen receptors. J Clin Invest. 1998;102:1515–25.
Schroeder Jr HW, Dighiero G. The pathogenesis of chronic lymphocytic leukemia: analysis of the antibody repertoire. Immunol Today. 1994;15:288–94.
Damle RN, Ghiotto F, Valetto A, Albesiano E, Fais F, Yan XJ, et al. B-cell chronic lymphocytic leukemia cells express a surface membrane phenotype of activated, antigen-experienced B lymphocytes. Blood. 2002;99:4087–93.
Stevenson FK, Caligaris-Cappio F. Chronic lymphocytic leukemia: revelations from the B-cell receptor. Blood. 2004;103:4389–95.
Klein U, Tu Y, Stolovitzky GA, Mattioli M, Cattoretti G, Husson H, et al. Gene expression profiling of B cell chronic lymphocytic leukemia reveals a homogeneous phenotype related to memory B cells. J Exp Med. 2001;194:1625–38.
Murray F, Darzentas N, Hadzidimitriou A, Tobin G, Boudjogra M, Scielzo C, et al. Stereotyped patterns of somatic hypermutation in subsets of patients with chronic lymphocytic leukemia: implications for the role of antigen selection in leukemogenesis. Blood. 2008;111:1524–33.
Stamatopoulos K, Belessi C, Moreno C, Boudjograh M, Guida G, Smilevska T, et al. Over 20% of patients with chronic lymphocytic leukemia carry stereotyped receptors: pathogenetic implications and clinical correlations. Blood. 2007;109:259–70.
Yuille MR, Matutes E, Marossy A, Hilditch B, Catovsky D, Houlston RS. Familial chronic lymphocytic leukaemia: a survey and review of published studies. Br J Haematol. 2000;109:794–9.
Jonsson V, Houlston RS, Catovsky D, Yuille MR, Hilden J, Olsen JH, et al. CLL family ‘Pedigree 14’ revisited: 1947-2004. Leukemia. 2005;19:1025–8.
Linet MS, Van Natta ML, Brookmeyer R, Khoury MJ, McCaffrey LD, Humphrey RL, et al. Familial cancer history and chronic lymphocytic leukemia. A case-control study. Am J Epidemiol. 1989;130:655–64.
Goldin LR, Pfeiffer RM, Li X, Hemminki K. Familial risk of lymphoproliferative tumors in families of patients with chronic lymphocytic leukemia: results from the Swedish Family-Cancer Database. Blood. 2004;104:1850–4.
Gunz FW, Gunz JP, Veale AM, Chapman CJ, Houston IB. Familial leukaemia: a study of 909 families. Scand J Haematol. 1975;15:117–31.
Giles GG, Lickiss JN, Baikie MJ, Lowenthal RM, Panton J. Myeloproliferative and lymphoproliferative disorders in Tasmania, 1972-80: occupational and familial aspects. J Natl Cancer Inst. 1984;72:1233–40.
Goldgar DE, Easton DF, Cannon-Albright LA, Skolnick MH. Systematic population-based assessment of cancer risk in first-degree relatives of cancer probands. J Natl Cancer Inst. 1994;86:1600–8.
Cartwright RA, Bernard SM, Bird CC, Darwin CM, O’Brien C, Richards ID, et al. Chronic lymphocytic leukaemia: case control epidemiological study in Yorkshire. Br J Cancer. 1987;56:79–82.
Pottern LM, Linet M, Blair A, Dick F, Burmeister LF, Gibson R, et al. Familial cancers associated with subtypes of leukemia and non-Hodgkin’s lymphoma. Leuk Res. 1991;15:305–14.
Goldin LR, Bjorkholm M, Kristinsson SY, Turesson I, Landgren O. Elevated risk of chronic lymphocytic leukemia and other indolent non-Hodgkin’s lymphomas among relatives of patients with chronic lymphocytic leukemia. Haematologica. 2009;94:647–53.
Ishibe N, Sgambati MT, Fontaine L, Goldin LR, Jain N, Weissman N, et al. Clinical characteristics of familial B-CLL in the National Cancer Institute Familial Registry. Leuk Lymphoma. 2001;42:99–108.
Crowther-Swanepoel D, Wild R, Sellick G, Dyer MJ, Mauro FR, Cuthbert RJ, et al. Insight into the pathogenesis of chronic lymphocytic leukemia (CLL) through analysis of IgVH gene usage and mutation status in familial CLL. Blood. 2008;111:5691–3.
Wiernik PH, Ashwin M, Hu XP, Paietta E, Brown K. Anticipation in familial chronic lymphocytic leukaemia. Br J Haematol. 2001;113:407–14.
Horwitz M, Goode EL, Jarvik GP. Anticipation in familial leukemia. Am J Hum Genet. 1996;59:990–8.
Yuille MR, Houlston RS, Catovsky D. Anticipation in familial chronic lymphocytic leukaemia. Leukemia. 1998;12:1696–8.
Daugherty SE, Pfeiffer RM, Mellemkjaer L, Hemminki K, Goldin LR. No evidence for anticipation in lymphoproliferative tumors in population-based samples. Cancer Epidemiol Biomarkers Prev. 2005;14:1245–50.
Mauro FR, Giammartini E, Gentile M, Sperduti I, Valle V, Pizzuti A, et al. Clinical features and outcome of familial chronic lymphocytic leukemia. Haematologica. 2006;91:1117–20.
Brezinschek HP, Brezinschek RI, Lipsky PE. Analysis of the heavy chain repertoire of human peripheral B cells using single-cell polymerase chain reaction. J Immunol. 1995;155:190–202.
Hamblin TJ, Davis Z, Gardiner A, Oscier DG, Stevenson FK. Unmutated Ig V(H) genes are associated with a more aggressive form of chronic lymphocytic leukemia. Blood. 1999;94:1848–54.
Mockridge CI, Rahman A, Buchan S, Hamblin T, Isenberg DA, Stevenson FK, et al. Common patterns of B cell perturbation and expanded V4-34 immunoglobulin gene usage in autoimmunity and infection. Autoimmunity. 2004;37:9–15.
Kostareli E, Hadzidimitriou A, Stavroyianni N, Darzentas N, Athanasiadou A, Gounari M, et al. Molecular evidence for EBV and CMV persistence in a subset of patients with chronic lymphocytic leukemia expressing stereotyped IGHV4-34 B-cell receptors. Leukemia. 2009;23(5):919–24.
Goldin LR, Ishibe N, Sgambati M, Marti GE, Fontaine L, Lee MP, et al. A genome scan of 18 families with chronic lymphocytic leukaemia. Br J Haematol. 2003;121:866–73.
Sellick GS, Goldin LR, Wild RW, Slager SL, Ressenti L, Strom SS, et al. A high-density SNP genome-wide linkage search of 206 families identifies susceptibility loci for chronic lymphocytic leukemia. Blood. 2007;110:3326–33.
Sellick GS, Webb EL, Allinson R, Matutes E, Dyer MJ, Jonsson V, et al. A high-density SNP genomewide linkage scan for chronic lymphocytic leukemia-susceptibility loci. Am J Hum Genet. 2005;77:420–9.
Fuller SJ, Papaemmanuil E, McKinnon L, Webb E, Sellick GS, Dao-Ung LP, et al. Analysis of a large multi-generational family provides insight into the genetics of chronic lymphocytic leukemia. Br J Haematol. 2008;142(2):238–45.
Raval A, Tanner SM, Byrd JC, Angerman EB, Perko JD, Chen SS, et al. Downregulation of death-associated protein kinase 1 (DAPK1) in chronic lymphocytic leukemia. Cell. 2007;129:879–90.
Houlston RS, Peto J. The future of association studies of common cancers. Hum Genet. 2003;112:434–5.
Di Bernardo MC, Crowther-Swanepoel D, Broderick P, Webb E, Sellick G, Wild R, et al. A genome-wide association study identifies six susceptibility loci for chronic lymphocytic leukemia. Nat Genet. 2008;40:1204–10.
Crowther-Swanepoel D, Broderick P, Di Bernardo MC, Dobbins SE, Torres M, Mansouri M, et al. Common variants at 2q37.3, 8q24.21, 15q21.3 and 16q24.1 influence chronic lymphocytic leukemia risk. Nat Genet. 2010;42:132–6.
Slager SL, Skibola CF, Di Bernardo MC, Conde L, Broderick P, McDonnell SK, et al. Common variation at 6p21.31 (BAK1) influences the risk of chronic lymphocytic leukemia. Blood. 2012;120:843–6.
Crowther-Swanepoel D, Mansouri M, Enjuanes A, Vega A, Smedby KE, Ruiz-Ponte C, et al. Verification that common variation at 2q37.1, 6p25.3, 11q24.1, 15q23, and 19q13.32 influences chronic lymphocytic leukaemia risk. Br J Haematol. 2010;150(4):473–9.
Slager SL, Goldin LR, Strom SS, Lanasa MC, Spector LG, Rassenti L, et al. Genetic susceptibility variants for chronic lymphocytic leukemia. Cancer Epidemiol Biomarkers Prev. 2010;19:1098–102.
Crowther-Swanepoel D, Di Bernardo MC, Jamroziak K, Karabon L, Frydecka I, Deaglio S, et al. Common genetic variation at 15q25.2 impacts on chronic lymphocytic leukaemia risk. Br J Haematol. 2011;154:229–33.
Rawstron AC, Green MJ, Kuzmicki A, Kennedy B, Fenton JA, Evans PA, et al. Monoclonal B lymphocytes with the characteristics of “indolent” chronic lymphocytic leukemia are present in 3.5% of adults with normal blood counts. Blood. 2002;100:635–9.
Rawstron AC, Bennett FL, O’Connor SJ, Kwok M, Fenton JA, Plummer M, et al. Monoclonal B-cell lymphocytosis and chronic lymphocytic leukemia. N Engl J Med. 2008;359:575–83.
Marti GE, Carter P, Abbasi F, Washington GC, Jain N, Zenger VE, et al. B-cell monoclonal lymphocytosis and B-cell abnormalities in the setting of familial B-cell chronic lymphocytic leukemia. Cytometry B Clin Cytom. 2003;52:1–12.
Rawstron AC, Yuille MR, Fuller J, Cullen M, Kennedy B, Richards SJ, et al. Inherited predisposition to CLL is detectable as subclinical monoclonal B-lymphocyte expansion. Blood. 2002;100:2289–90.
Busslinger M. Transcriptional control of early B cell development. Annu Rev Immunol. 2004;22:55–79.
Klein U, Casola S, Cattoretti G, Shen Q, Lia M, Mo T, et al. Transcription factor IRF4 controls plasma cell differentiation and class-switch recombination. Nat Immunol. 2006;7:773–82.
Xu D, Zhao L, Del Valle L, Miklossy J, Zhang L. Interferon regulatory factor 4 is involved in Epstein-Barr virus-mediated transformation of human B lymphocytes. J Virol. 2008;82:6251–8.
Adami J, Frisch M, Yuen J, Glimelius B, Melbye M. Evidence of an association between non-Hodgkin’s lymphoma and skin cancer. BMJ. 1995;310:1491–5.
Swerdlow AJ, Storm HH, Sasieni PD. Risks of second primary malignancy in patients with cutaneous and ocular melanoma in Denmark, 1943-1989. Int J Cancer. 1995;61:773–9.
Han J, Kraft P, Nan H, Guo Q, Chen C, Qureshi A, et al. A genome-wide association study identifies novel alleles associated with hair color and skin pigmentation. PLoS Genet. 2008;4:e1000074.
Pho LN, Leachman SA. Genetics of pigmentation and melanoma predisposition. G Ital Dermatol Venereol. 2010;145:37–45.
Chipuk JE, Moldoveanu T, Llambi F, Parsons MJ, Green DR. The BCL-2 family reunion. Mol Cell. 2010;37:299–310.
Takeuchi O, Fisher J, Suh H, Harada H, Malynn BA, Korsmeyer SJ. Essential role of BAX, BAK in B cell homeostasis and prevention of autoimmune disease. Proc Natl Acad Sci U S A. 2005;102:11272–7.
Bloch DB, de la Monte SM, Guigaouri P, Filippov A, Bloch KD. Identification and characterization of a leukocyte-specific component of the nuclear body. J Biol Chem. 1996;271:29198–204.
Dent AL, Yewdell J, Puvion-Dutilleul F, Koken MH, de The H, Staudt LM. LYSP100-associated nuclear domains (LANDs): description of a new class of subnuclear structures and their relationship to PML nuclear bodies. Blood. 1996;88:1423–6.
Ling PD, Peng RS, Nakajima A, Yu JH, Tan J, Moses SM, et al. Mediation of Epstein-Barr virus EBNA-LP transcriptional coactivation by Sp100. EMBO J. 2005;24:3565–75.
Madani N, Millette R, Platt EJ, Marin M, Kozak SL, Bloch DB, et al. Implication of the lymphocyte-specific nuclear body protein Sp140 in an innate response to human immunodeficiency virus type 1. J Virol. 2002;76:11133–8.
Page-McCaw PS, Amonlirdviman K, Sharp PA. PUF60: a novel U2AF65-related splicing activity. RNA. 1999;5:1548–60.
Duncan R, Bazar L, Michelotti G, Tomonaga T, Krutzsch H, Avigan M, et al. A sequence-specific, single-strand binding protein activates the far upstream element of c-myc and defines a new DNA-binding motif. Genes Dev. 1994;8:465–80.
Liu J, He L, Collins I, Ge H, Libutti D, Li J, et al. The FBP interacting repressor targets TFIIH to inhibit activated transcription. Mol Cell. 2000;5:331–41.
Kovalevska LM, Yurchenko OV, Shlapatska LM, Berdova GG, Mikhalap SV, Van Lint J, et al. Immunohistochemical studies of protein kinase D (PKD) 2 expression in malignant human lymphomas. Exp Oncol. 2006;28:225–30.
Miyamoto Y, Yamauchi J, Itoh H. Src kinase regulates the activation of a novel FGD-1-related Cdc42 guanine nucleotide exchange factor in the signaling pathway from the endothelin A receptor to JNK. J Biol Chem. 2003;278:29890–900.
Ikeda M, Longnecker R. The c-Cbl proto-oncoprotein downregulates EBV LMP2A signaling. Virology. 2009;385:183–91.
Gudmundsson J, Sulem P, Manolescu A, Amundadottir LT, Gudbjartsson D, Helgason A, et al. Genome-wide association study identifies a second prostate cancer susceptibility variant at 8q24. Nat Genet. 2007;39:631–7.
Easton DF, Pooley KA, Dunning AM, Pharoah PD, Thompson D, Ballinger DG, et al. Genome-wide association study identifies novel breast cancer susceptibility loci. Nature. 2007;447:1087–93.
Tomlinson I, Webb E, Carvajal-Carmona L, Broderick P, Kemp Z, Spain S, et al. A genome-wide association scan of tag SNPs identifies a susceptibility variant for colorectal cancer at 8q24.21. Nat Genet. 2007;39:984–8.
Yeager M, Orr N, Hayes RB, Jacobs KB, Kraft P, Wacholder S, et al. Genome-wide association study of prostate cancer identifies a second risk locus at 8q24. Nat Genet. 2007;39:645–9.
Amundadottir LT, Sulem P, Gudmundsson J, Helgason A, Baker A, Agnarsson BA, et al. A common variant associated with prostate cancer in European and African populations. Nat Genet. 2006;38:652–8.
Kiemeney LA, Thorlacius S, Sulem P, Geller F, Aben KK, Stacey SN, et al. Sequence variant on 8q24 confers susceptibility to urinary bladder cancer. Nat Genet. 2008;40:1307–12.
Pomerantz MM, Ahmadiyeh N, Jia L, Herman P, Verzi MP, Doddapaneni H, et al. The 8q24 cancer risk variant rs6983267 shows long-range interaction with MYC in colorectal cancer. Nat Genet. 2009;41:882–4.
Shaffer AL, Emre NC, Lamy L, Ngo VN, Wright G, **ao W, et al. IRF4 addiction in multiple myeloma. Nature. 2008;454:226–31.
Crowther-Swanepoel D, Corre T, Lloyd A, Gaidano G, Olver B, Bennett FL, et al. Inherited genetic susceptibility to monoclonal B-cell lymphocytosis. Blood. 2010;116:5957–60.
Di Bernardo MC, Broderick P, Catovsky D, Houlston R. Common genetic variation contributes significantly to the risk of develo** chronic lymphocytic leukemia. Haematologica. 2013;98(3):e23–4.
Hamblin TJ. Autoimmune complications of chronic lymphocytic leukemia. Semin Oncol. 2006;33:230–9.
Analo HI, Akanmu AS, Akinsete I, Njoku OS, Okany CC. Seroprevalence study of HTLV-1 and HIV infection in blood donors and patients with lymphoid malignancies in Lagos, Nigeria. Cent Afr J Med. 1998;44:130–4.
Landgren O, Pfeiffer RM, Stewart L, Gridley G, Mellemkjaer L, Hemminki K, et al. Risk of second malignant neoplasms among lymphoma patients with a family history of cancer. Int J Cancer. 2007;120:1099–102.
Landgren O, Rapkin JS, Caporaso NE, Mellemkjaer L, Gridley G, Goldin LR, et al. Respiratory tract infections and subsequent risk of chronic lymphocytic leukemia. Blood. 2007;109:2198–201.
Di Bernardo MC, Broderick P, Harris S, Dyer MJ, Matutes E, Dearden C, et al. Risk of develo** chronic lymphocytic leukemia is influenced by HLA-A class I variation. Leukemia. 2013;27(1):255–8.
Damle RN, Calissano C, Chiorazzi N. Chronic lymphocytic leukaemia: a disease of activated monoclonal B cells. Best Pract Res Clin Haematol. 2010;23:33–45.
Zhang SY, Gu HX, Li D, Yang SF, Zhong ZH, Li XK, et al. Association of human leukocyte antigen polymorphism with hepatitis B virus infection and genotypes. Jpn J Infect Dis. 2006;59:353–7.
Souza CF, Noguti EN, Visentainer JE, Cardoso RF, Petzl-Erler ML, Tsuneto LT. HLA and MICA genes in patients with tuberculosis in Brazil. Tissue Antigens. 2012;79:58–63.
Bergamaschi L, Leone MA, Fasano ME, Guerini FR, Ferrante D, Bolognesi E, et al. HLA-class I markers and multiple sclerosis susceptibility in the Italian population. Genes Immun. 2011;11:173–80.
Niens M, Jarrett RF, Hepkema B, Nolte IM, Diepstra A, Platteel M, et al. HLA-A*02 is associated with a reduced risk and HLA-A*01 with an increased risk of develo** EBV+ Hodgkin lymphoma. Blood. 2007;110:3310–5.
Bei JX, Li Y, Jia WH, Feng BJ, Zhou G, Chen LZ, et al. A genome-wide association study of nasopharyngeal carcinoma identifies three new susceptibility loci. Nat Genet. 2010;42:599–603.
Acknowledgements
Work in the author’s laboratory is supported by the Leukaemia Lymphoma Research, Cancer Research UK and the Arbib Foundation. GS is in receipt of a PhD studentship from the Institute of Cancer Research.
Conflict of interest: The authors declare that there are no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Speedy, H.E., Sava, G., Houlston, R.S. (2013). Inherited Susceptibility to CLL. In: Malek, S. (eds) Advances in Chronic Lymphocytic Leukemia. Advances in Experimental Medicine and Biology, vol 792. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8051-8_13
Download citation
DOI: https://doi.org/10.1007/978-1-4614-8051-8_13
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-8050-1
Online ISBN: 978-1-4614-8051-8
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)