Hansen Quinty, Bachas Costa, Smit Linda, Cloos Jacqueline
Department of Hematology, Amsterdam UMC, Location VUmc, Cancer Center Amsterdam, Amsterdam 1081HV, The Netherlands.
Cancer Drug Resist. 2022 May 5;5(2):344-367. doi: 10.20517/cdr.2021.140. eCollection 2022.
In acute myeloid leukemia (AML), a small cell population that contains stem cell features such as lack of differentiation, self-renewal potential, and drug resistance, can be identified. These so-called leukemic stem cells (LSCs) are thought to be responsible for relapse initiation after initial treatment leading to successful eradication of the bulk AML cell population. Since many studies have aimed to characterize and eliminate LSCs to prevent relapse and increase survival rates of patients, LSCs are one of the best characterized cancer stem cells. The specific elimination of LSCs, while sparing the healthy normal hematopoietic stem cells (HSCs), is one of the major challenges in the treatment of leukemia. This review focuses on several surface markers and intracellular transcription factors that can distinguish AML LSCs from HSCs and, therefore, specifically eliminate these stem cell-like leukemic cells. Moreover, previous and ongoing clinical trials of acute leukemia patients treated with therapies targeting these markers are discussed. In contrast to knowledge on LSCs in AML, insight into LSCs in acute lymphoid leukemia (ALL) is limited. This review therefore also addresses the latest insight into LSCs in ALL.
在急性髓系白血病（AML）中，可以识别出一小部分具有干细胞特征的细胞群体，这些特征包括缺乏分化能力、自我更新潜力和耐药性。这些所谓的白血病干细胞（LSCs）被认为是导致初始治疗成功清除大部分AML细胞群体后复发的原因。由于许多研究旨在表征和消除LSCs以预防复发并提高患者生存率，LSCs是特征最明确的癌症干细胞之一。在不损伤健康正常造血干细胞（HSCs）的情况下特异性消除LSCs是白血病治疗中的主要挑战之一。本综述重点关注几种能够区分AML LSCs和HSCs的表面标志物和细胞内转录因子，从而特异性消除这些干细胞样白血病细胞。此外，还讨论了针对这些标志物进行治疗的急性白血病患者的既往和正在进行的临床试验。与AML中LSCs的知识相比，对急性淋巴细胞白血病（ALL）中LSCs的了解有限。因此，本综述还阐述了对ALL中LSCs的最新认识。
