CBS Newsman Ed Bradley Dies of CLL Complications

NEW YORK, Nov. 9 -- Veteran television reporter Ed Bradley has died of complications of chronic lymphocytic leukemia (CLL) at the age of 65.

Bradley, a co-anchor of the CBS newsmagazine "60 Minutes," was diagnosed with CLL "many years ago," according to Valentin Fuster, M.D., Ph.D., his cardiologist and the director of Mount Sinai Heart at the Mount Sinai Medical Center, where Bradley died.

However, Dr. Fuster told reporters, the disease was not life-threatening until recently when Bradley contracted an infection that his damaged immune system was unable to defeat.

CLL is characterized by a progressive accumulation of functionally incompetent lymphocytes and is the most common form of leukemia among adults. Up to 17,000 new cases are reported yearly in the U.S.

The incidence is similar in most Western countries, but the disease is rare in Asian countries. In Japan, for instance, only 10% of all leukemias are CLL.

In most cases, the affected lymphocytes are B-cells, arrested in the process of differentiation between pre-B-cells and mature B-cells. They resemble mature lymphocytes, but express low levels of surface membrane immunoglobulin.

The disease is most often seen in people older the 55, although the rate of occurrence in younger people is rising.

The natural history of the disease is highly variable. Some patients die quickly because of CLL complications but the majority of patients live between five and 10 years.

CLL has a wide range of symptoms and it is relatively common for a diagnosis to be made after a blood cell count performed for another reason. Among the symptoms:

• A predisposition to repeated infections.
• Enlarged lymph nodes and localized or generalized lymph node infections.
• Splenomegaly occurs in between 30 and 40% of cases, and patients may complain of early satiety or abdominal discomfort because of the enlarged spleen.
• Hepatomegaly occurs in about 20% of cases.
• Patients may suffer bleeding in the mucous membranes or petechiae owing to thrombocytopenia.
• Patients may have tiredness and fatigue because of anemia.

In most cases, treatment at diagnosis is not indicated, unless the disease is aggressive, because studies have shown that early therapy has little advantage. Treatment options include:

• Prednisolone alone may be useful in patients whose disease has aspects of autoimmunity.
• Nucleoside analogs, such as Fludara (fludarabine) and Leustatin (cladribine), have activity against indolent lymphoid malignancies, including CLL.
• Combination regimens, such as cyclophosphamide, doxorubicin, and prednisone (CAP), have shown good response rates in several studies but no survival advantage.
• Monoclonal antibodies, such as Rituxan (rituximab), are in use as second-line or third-line treatments and new agents are in clinical trials.

Bradley was awarded 19 Emmys, including one for a report on the reopening of the 50-year-old racial murder case of Emmett Till and another for interview with condemned Oklahoma City bomber Timothy McVeigh, according to CBS.