缓解期骨小梁间区聚集的幼稚髓系前体细胞起源于靠近骨内膜的白血病干细胞，并导致急性髓系白血病疾病复发。

Clustered immature myeloid precursors in intertrabecular region during remission evolve from leukemia stem cell near endosteum and contribute to disease relapse in acute myeloid leukemia.

机构信息

Department of Hematology, The Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China.

出版信息

Med Hypotheses. 2013 May;80(5):624-8. doi: 10.1016/j.mehy.2013.02.005. Epub 2013 Mar 6.

DOI:10.1016/j.mehy.2013.02.005

PMID:23474071

Abstract

Most acute myeloid leukemia (AML) cannot be cured because leukemia stem cells (LSC) will contribute to eventual relapse. However, how LSC initiate relapse is not yet fully understood. We performed a retrospective study on bone marrow sections from AML patients during complete remission (CR), demonstrating that single and double immature myeloid precursors were located near endosteum and clustered precursors (≥ 3 cells/group) in intertrabecular region. Based on our observations, we hypothesize that after retrieval of myelotoxic regimen, LSC harboring near endosteum divide and differentiate into progeny cells which proliferate and then form colony clusters. Meanwhile, these clusters may migrate to intertrabecular region under the actions of cell migration factors. Without any interventions, clustered immature myeloid precursors may proliferate and hematologic relapse is then unavoidable.

摘要

大多数急性髓系白血病（AML）无法治愈，因为白血病干细胞（LSC）会导致最终复发。然而，LSC 如何引发复发尚未完全了解。我们对完全缓解（CR）期间 AML 患者的骨髓切片进行了回顾性研究，结果表明，单个和双个不成熟髓样前体位于骨内膜附近，簇状前体（≥ 3 个细胞/组）位于骨小梁间区。基于我们的观察，我们假设在回收骨髓抑制方案后，靠近骨内膜的 LSC 分裂并分化为祖细胞，这些祖细胞增殖，然后形成集落簇。同时，在细胞迁移因子的作用下，这些簇可能迁移到骨小梁间区。如果没有任何干预，簇状不成熟髓样前体可能会增殖，随后不可避免地出现血液学复发。