Hanekamp Diana, Cloos Jacqueline, Schuurhuis Gerrit Jan
Department of Hematology, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
Department of Paediatric Oncology/Hematology, VU University Medical Center, Amsterdam, The Netherlands.
Int J Hematol. 2017 May;105(5):549-557. doi: 10.1007/s12185-017-2221-5. Epub 2017 Mar 29.
Leukemic stem cells (LSCs) in acute myeloid leukemia (AML) represent a low-frequency subpopulation of leukemia cells that possess stem cell properties distinct from the bulk leukemia cells, including self-renewal capacity and drug resistance. Due to these properties, LSCs are supposed to facilitate the development of relapse. The existence of LSCs is demonstrated by the ability to engraft and initiate human AML in immune-compromised mouse models. Although several lines of evidence suggest the complex heterogeneity of phenotypes displayed by LSC, many studies consider the CD34+/CD38- compartment as the most relevant. To increase the understanding of the true LSC, techniques such as multicolor flow cytometry, side-population assay and ALDH assay are utilized in many laboratories and could aid in this. A better understanding of different LSC phenotypes is necessary to enhance risk group classification, guide clinical decision-making and to identify new therapeutic targets. These efforts to eliminate LSC should ultimately improve the dismal AML outcome by preventing relapse development.
急性髓系白血病（AML）中的白血病干细胞（LSCs）是白血病细胞中的一个低频亚群，具有与大多数白血病细胞不同的干细胞特性，包括自我更新能力和耐药性。由于这些特性，LSCs被认为会促进复发的发生。LSCs的存在通过在免疫缺陷小鼠模型中植入并引发人类AML的能力得以证明。尽管有几条证据表明LSC显示出复杂的表型异质性，但许多研究认为CD34+/CD38-亚群最为相关。为了增进对真正的LSC的理解，许多实验室采用了多色流式细胞术、侧群分析和醛脱氢酶（ALDH）分析等技术，这些技术有助于实现这一目标。更好地理解不同的LSC表型对于加强风险组分类、指导临床决策以及识别新的治疗靶点是必要的。这些消除LSC的努力最终应通过预防复发的发生来改善AML令人沮丧的治疗结果。
