Interplay of IL4 and CCL2 / CCL3 axis in Patients with chronic lymphocytic leukemia

Author(s): Hawraa S.S, Mohammed R. S. AL-Attabi
Date: 09/10/2026
doi: https://doi.org/10.5281/zenodo.8425890

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Abstract

Background: 
The most prevalent leukemia in adulthood is chronic lymphocytic leukemia (CLL), which is a gradual and 
progressive build up of monoclonal B cells. A favorable microenvironment with the presence of cytokines 
and chemokines has a strong impact on this process. Among them, IL-4, CCL2, and CCL3 are critical 
factors that contribute to increasing the leukemic cell survival and reducing the inflammatory contact, as 
well as influencing the communication between the malignant cells and stroma. 
Aim: 
The purpose of the study was to determine serum concentrations of IL-4, CCL2 and CCL3 in untreated 
patients with newly diagnosed CLL, compare them with normal subjects and determine their diagnostic 
value and the relationship between them and hematological and clinical variables. 
Methods: 
It was a case-control study that comprised of 60 newly diagnosed CLL patients and 30 healthy controls. 
Hematological parameters were analyzed with the help of an automated analyzer (WBC count, 
lymphocytes, neutrophils, and monocytes). ELISA was used to measure serum IL-4, CCL2 and CCL3 
using standard manufacturer procedures. Group comparisons, ROC curve analysis, and correlation tests 
were performed to compare the groups statistically with the significance value of P ≤ 0.05. 
Results: 
The patients of CLL showed a great increase in the count of WBC, lymphocyte and monocyte counts than 
the healthy individuals. The levels of serum IL-4, CCL2 and CCL3 were significantly elevated in the 
group of patients (P<0.001). 
ROC showed that CCL2 showed an excellent diagnostic ability (AUC = 0.905), CCL3 was good (AUC = 
0.870), and IL4 was average (AUC = 0.707). 

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