According to research reviewed by Gram, blood cancer cells in chronic lymphocytic leukemia appear to pick up a protein called FOLR2 from nearby support cells, and FOLR2-carrying cells were the predominant group of actively dividing leukemia cells in the study. This is laboratory research and does not show that folate intake affects the disease.
According to research reviewed by Gram, scientists studying chronic lymphocytic leukemia (CLL), a slow-growing blood cancer, found that cancer cells can pick up a protein called FOLR2 from nearby helper immune cells. The protein appears to help the cancer cells take in folate, a B vitamin, and may support their ability to grow and multiply. The team used samples from patients and found that the cancer cells with this protein were the ones most actively dividing. They also found more of these helper cells in lymph node samples from more aggressive cases. This work is laboratory research, so it does not show that diet or vitamins change the course of the disease. It does point to FOLR2 as a possible marker for identifying harmful cell activity and a possible target for future treatments. Patients should continue to follow their doctor’s guidance rather than change their diet or supplements based on this study alone.
Key Statistics
A 2026 laboratory study published in Haematologica, using primary patient cells, found that FOLR2-positive chronic lymphocytic leukemia cells represented the predominant population of actively cycling leukemic cells.
The same 2026 Haematologica study found that FOLR2-positive nurse-like support cells were significantly enriched in more aggressive and more proliferative cases of chronic lymphocytic leukemia in lymph node tissue analysis.
The Quick Take
- What they studied: Scientists wanted to know how blood cancer cells in chronic lymphocytic leukemia communicate with the surrounding immune environment and whether they gain helpful proteins from nearby support cells.
- Who participated: The study used cells taken from patients with CLL, along with lymph node tissue samples from patients with the disease. The exact number of participants was not stated in the summary provided.
- Key finding: Cancer cells appeared to acquire a protein called FOLR2 from nearby helper cells. The cancer cells that had this protein were the predominant group of actively dividing leukemia cells, which suggests a link between the protein and cell growth.
- What it means for you: This is early laboratory research and does not provide dietary advice. It does not show that eating more or less folate changes CLL risk or progression. Anyone with CLL should talk with their oncologist before making changes to diet or supplements.
The Research Details
Researchers began by collecting immune and cancer cells from patients with CLL and studying them in laboratory dishes. They looked at a group of supportive immune cells, called nurse-like cells, which are known to help leukemia cells survive. They found these support cells had high levels of FOLR2, and that higher levels were linked to leukemia cells living longer in the lab.
Next, the team copied conditions that may occur in the lymph nodes by adding two signaling molecules, CD40L and IL-15, to the cells. Under these conditions, more FOLR2 moved from the support cells to the cancer cells, and the cancer cells became more active and began dividing. The researchers also tested whether FOLR2 could move through tiny packets released by cells, called extracellular vesicles, in addition to direct cell contact.
Finally, the team examined lymph node tissue from CLL patients using a method that labels several proteins at once in the same slice of tissue. This allowed them to see where FOLR2-carrying cells were located and to compare cases that were more aggressive or more active.
Testing cells in the lab lets researchers control conditions and see exactly how proteins move between cells. Checking the same findings in real lymph node tissue from patients helps show that the process is not just a laboratory artifact. Together, these approaches make the results more believable than either method alone.
The study was published in Haematologica, a peer-reviewed journal focused on blood disorders. It used primary patient cells and patient tissue, which makes the findings more relevant to real disease than cell lines alone. However, the sample size was not specified, laboratory results often do not carry over directly to people, and the study did not test any treatment or dietary change in patients.
What the Results Show
The first main result was that nurse-like support cells in CLL contained high levels of FOLR2, and that higher levels were associated with leukemia cells surviving longer in the laboratory. This suggests the protein may be part of how the surrounding environment helps cancer cells persist.
The second main result was that CLL cells appeared to take up FOLR2 from the support cells through a process called trogocytosis, in which one cell pulls a piece of another cell’s surface into itself. The researchers reported that this transfer increased the cancer cells’ ability to take in folate, a B vitamin that cells use to make building blocks for growth.
When the researchers copied lymph node signals with CD40L and IL-15, the transfer of FOLR2 increased sharply. The cancer cells that carried FOLR2 were the main group of cells that were actively dividing. This pattern links the protein to cell activation and growth, although a laboratory link does not prove cause and effect.
The team also found signs of a second transfer route that did not require direct contact between cells, possibly through extracellular vesicles. In lymph node samples, they confirmed FOLR2-positive support cells and found them more concentrated in more aggressive and more proliferative cases of CLL.
FOLR2-positive cancer cells were found directly inside lymph node tissue, which supports the idea that this transfer happens in the real disease environment and not only in the lab. The research also suggests FOLR2 could serve as a marker for identifying the protective support cells, which may help scientists sort patients or study disease behavior in the future. These findings are interesting for research direction, but they do not yet change how CLL is diagnosed or treated.
Earlier research has described nurse-like cells as an important part of the CLL support environment, and this study builds on that idea by identifying a specific protein that moves between cells. The idea that cancer cells can borrow proteins from neighboring cells is a growing area of cancer biology. This paper adds a specific example involving folate uptake, but further studies will be needed to confirm how broadly this applies.
The study was largely conducted in laboratory settings, and lab conditions cannot fully match the complexity of a living body. The sample size was not clearly reported in the information provided, which makes it harder to judge how widely the results apply. The study did not test whether blocking FOLR2 or changing folate levels slows disease in patients, so no treatment conclusions can be drawn. Some mechanisms, especially the role of tiny vesicles, were described as possible rather than proven.
The Bottom Line
Confidence is moderate that FOLR2 transfer is part of how CLL cells gain activity in the lab, because the findings were consistent across cell experiments and lymph node tissue. Confidence is low that this finding leads to any change in patient care now. No dietary or supplement recommendations can be made from this study. Patients should keep following established treatment plans.
Researchers studying blood cancers, immune cell communication, and new treatment targets will find this work most useful. Patients and families affected by CLL may be interested in the research direction but should not change diet or supplements based on it. People without CLL should not draw health conclusions from this study.
Laboratory discoveries like this usually take years before they reach clinical testing. Any future treatment or diagnostic tool based on FOLR2 would need separate studies in patients, which often take several years. Patients should not expect changes in care based on this paper in the near term.
Frequently Asked Questions
What is FOLR2 and why does it matter in leukemia?
FOLR2 is a protein that helps cells take in folate, a B vitamin. A 2026 Haematologica study found that leukemia cells in chronic lymphocytic leukemia can acquire FOLR2 from nearby support cells, and this appeared linked to more active cancer cell growth in laboratory tests.
Does folate intake affect chronic lymphocytic leukemia?
This study did not test folate intake or diet in patients. It examined how cancer cells gain a folate-related protein in laboratory and tissue samples. Anyone with chronic lymphocytic leukemia should discuss nutrition and supplements with their oncologist before making changes.
Can this research lead to a new treatment for leukemia?
The research identifies FOLR2 as a possible marker of protective support cells and a potential target for future studies. Turning this into a treatment would require further laboratory work and clinical trials in patients, a process that usually takes several years.
What is trogocytosis in simple terms?
Trogocytosis is a process where one cell takes a small piece of another cell’s surface and absorbs it. In this study, cancer cells in chronic lymphocytic leukemia appeared to use this process to receive FOLR2 from nearby nurse-like support cells.
Want to Apply This Research?
- Because this research is laboratory-based and does not link to food intake, the app should not prompt users to track folate or vitamin intake based on this study. If a user has CLL and is working with their care team, they may track symptoms such as fatigue, swollen lymph nodes, infections, and lab results they share with their doctor.
- The app can encourage users to bring questions about new research to their oncologist and to keep a written list of questions for each appointment. It can also remind users not to start new supplements, including high-dose folate, without checking with their care team.
- Over the long term, users with CLL can keep a simple log of symptoms, appointment notes, and lab results that their doctor reviews. Users should check back for updates from trusted sources, since future studies may clarify whether FOLR2 becomes a useful marker or treatment target.
This article summarizes early laboratory and tissue research published in Haematologica. The findings have not been tested as a treatment or dietary approach in patients and should not be used to change diet, supplements, or medical care. Anyone with chronic lymphocytic leukemia or another blood condition should consult their oncologist or healthcare provider before making decisions based on this research.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.