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In lymphoproliferative neoplasms including chronic lymphocytic leukemia (CLL), hairy cell leukemia and even multiple myeloma, the biology of the monoclonal cells as well as the surrounding cells which are called microenvironment of the bone marrow are known to be in an interplay. Before the understanding of the importance of microenvironment, these malignancies were treated with cytotoxic agents which are aimed towards the actively DNA replicating cells. As the low grade lymphoproliferative malignancies replicate much slower, these agents generally did not achieve an adequate response despite their heavy treatment related burdens like toxicities.

CD8 Expression on Clonal B-CLL cells and CD8+ Lymphocytes in the Microenvironment, Relations with Prognosis and Survival