Bernt Kathrin M, Armstrong Scott A
Division of Hematology/Oncology, Children's Hospital, and Department of Pediatric Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA.
Semin Hematol. 2009 Jan;46(1):33-8. doi: 10.1053/j.seminhematol.2008.09.010.
Leukemias and other cancers have been proposed to contain a subpopulation of cells that display characteristics of stem cells and maintain tumor growth. The fact that most anticancer therapy is directed against the bulk of the tumor, and possibly spares the cancer stem cells, may lie at the heart of treatment failures with conventional modalities. Leukemia stem cells are fairly well described for acute myeloid leukemia (AML), but their existence and relevance for acute lymphoblastic leukemia (ALL) is less clear. Several reports describe subpopulations with primitive phenotypes in clinical ALL samples. However, it has also been suggested that the majority of leukemic subfractions can propagate leukemia in the appropriate experimental setting, and that their hierarchical organization is less strict than in AML. In addition, it is uncertain whether cancer stem cells arise from malignant transformation of a tissue-specific stem cell, or from committed progenitors or differentiated cells that re-acquire a stem cell-like program. In common childhood ALL, current evidence points towards the cell of origin being a committed lymphoid progenitor. In this review, we highlight recent findings relating to the question of leukemia stem cells in ALL.
白血病和其他癌症被认为含有一群具有干细胞特征并维持肿瘤生长的细胞。大多数抗癌治疗针对的是肿瘤主体，可能会放过癌症干细胞，这一事实可能是传统治疗方式失败的核心原因。急性髓系白血病（AML）的白血病干细胞已得到相当充分的描述，但其在急性淋巴细胞白血病（ALL）中的存在及相关性尚不清楚。有几份报告描述了临床ALL样本中具有原始表型的亚群。然而，也有人提出，大多数白血病亚群在适当的实验环境中都能引发白血病，而且它们的层次结构不如AML严格。此外，尚不确定癌症干细胞是源自组织特异性干细胞的恶性转化，还是源自重新获得干细胞样程序的定向祖细胞或分化细胞。在常见的儿童ALL中，目前的证据表明起源细胞是定向淋巴祖细胞。在这篇综述中，我们重点介绍了与ALL中白血病干细胞问题相关的最新研究结果。
