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急性髓系白血病中的药物耐受性持久细胞:紧迫的挑战与有前景的新治疗策略

Drug-tolerant persister cells in acute myeloid leukemia: pressing challenge and promising new strategies for treatment.

作者信息

Li Meng, Wang Xiaoli, He Wenjuan, Zhou Hao

机构信息

Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Front Med (Lausanne). 2025 May 14;12:1586552. doi: 10.3389/fmed.2025.1586552. eCollection 2025.


DOI:10.3389/fmed.2025.1586552
PMID:40443513
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12120853/
Abstract

Acute myeloid leukemia (AML) exhibits a pronounced ability to develop drug resistance and undergo disease relapse. Recent research has noticed that resistance to treatments could substantially be attributed to drug-tolerant persister (DTP) cells, which are capable of surviving under therapeutic pressures. These are transient, reversibly dormant cells with the capability to act as a reservoir for disease relapse. DTP cells utilize diverse adaptive strategies to optimize the ecological niche, undergo metabolic reprogramming, and interact with microenvironment. The persister state of AML is established through transient cellular reprogramming, thus allowing cells to survive the initial phase of drug therapy and develop drug resistance. Our review explores the identification and phenotypic characteristics of AML DTP cells, as well as their clinical relevance. We summarize the mechanisms underlying the persistence of AML DTP cells and the molecular attributes that define the DTP state. We further address the current challenges and future prospects of DTP-targeting approaches. Understanding these features may provide critical insights into novel therapeutic strategies aimed at targeting AML DTP cells, especially in the new era of immunotherapy against AML.

摘要

急性髓系白血病(AML)具有显著的产生耐药性和疾病复发的能力。最近的研究发现,对治疗的耐药性在很大程度上可归因于耐药持久性细胞(DTP),这些细胞能够在治疗压力下存活。它们是短暂的、可逆性休眠的细胞,能够作为疾病复发的细胞库。DTP细胞利用多种适应性策略来优化生态位、进行代谢重编程并与微环境相互作用。AML的持久性状态是通过短暂的细胞重编程建立的,从而使细胞能够在药物治疗的初始阶段存活并产生耐药性。我们的综述探讨了AML DTP细胞的鉴定和表型特征,以及它们的临床相关性。我们总结了AML DTP细胞持续存在的潜在机制以及定义DTP状态的分子特征。我们还进一步阐述了靶向DTP方法当前面临的挑战和未来前景。了解这些特征可能为针对AML DTP细胞的新型治疗策略提供关键见解,尤其是在抗AML免疫治疗的新时代。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eeb/12120853/5da2d07a43ad/fmed-12-1586552-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eeb/12120853/c820c9038acf/fmed-12-1586552-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eeb/12120853/0c907272e238/fmed-12-1586552-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eeb/12120853/2a9c9947d9ca/fmed-12-1586552-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eeb/12120853/5da2d07a43ad/fmed-12-1586552-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eeb/12120853/c820c9038acf/fmed-12-1586552-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eeb/12120853/0c907272e238/fmed-12-1586552-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eeb/12120853/2a9c9947d9ca/fmed-12-1586552-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eeb/12120853/5da2d07a43ad/fmed-12-1586552-g004.jpg

相似文献

[1]
Drug-tolerant persister cells in acute myeloid leukemia: pressing challenge and promising new strategies for treatment.

Front Med (Lausanne). 2025-5-14

[2]
Mechanism of Drug Tolerant Persister Cancer Cells: The Landscape and Clinical Implication for Therapy.

J Thorac Oncol. 2021-11

[3]
Acute myeloid leukemia drug-tolerant persister cells survive chemotherapy by transiently increasing plasma membrane rigidity, that also increases their sensitivity to immune cell killing.

Haematologica. 2025-4-1

[4]
Redox signaling in drug-tolerant persister cells as an emerging therapeutic target.

EBioMedicine. 2023-3

[5]
Mitochondrial fatty acid oxidation as the target for blocking therapy-resistance and inhibiting tumor recurrence: The proof-of-principle model demonstrated for ovarian cancer cells.

J Adv Res. 2025-3-17

[6]
Targeting of drug-tolerant persister cells as an approach to counter drug resistance in non-small cell lung cancer.

Lung Cancer. 2024-8

[7]
Targeting of FSP1 regulates iron homeostasis in drug-tolerant persister head and neck cancer cells via lipid-metabolism-driven ferroptosis.

Aging (Albany NY). 2024-1-10

[8]
Mitophagy is a novel protective mechanism for drug-tolerant persister (DTP) cancer cells.

Autophagy. 2023-9

[9]
Drug tolerant persister cell plasticity in cancer: A revolutionary strategy for more effective anticancer therapies.

Signal Transduct Target Ther. 2024-8-14

[10]
PINK1-Mediated Mitophagy Promotes Oxidative Phosphorylation and Redox Homeostasis to Induce Drug-Tolerant Persister Cancer Cells.

Cancer Res. 2023-2-3

本文引用的文献

[1]
Prognostic value of serum lipids in newly diagnosed acute promyelocytic leukemia.

Front Oncol. 2025-2-18

[2]
Pharmacogenomics influence on MDR1-associated cancer resistance and innovative drug delivery approaches: advancing precision oncology.

Med Oncol. 2025-2-6

[3]
Mitochondrial abnormalities as a target of intervention in acute myeloid leukemia.

Front Oncol. 2025-1-20

[4]
Metabolic orchestration of drug-tolerant persister cells in cancer.

Life Med. 2024-12-7

[5]
Single-cell RNA sequencing and machine learning provide candidate drugs against drug-tolerant persister cells in colorectal cancer.

Biochim Biophys Acta Mol Basis Dis. 2025-3

[6]
Inflammation and Immune Escape in Ovarian Cancer: Pathways and Therapeutic Opportunities.

J Inflamm Res. 2025-1-21

[7]
Editorial: Acute leukemias: molecular characterization, leukemia-initiating cells, and influence of the microenvironment, volume II.

Front Oncol. 2025-1-6

[8]
Efficacy and safety of hypomethylating agents in the treatment of AML/MDS patients relapsed post allogenetic hematopoietic stem cell transplantation.

Front Oncol. 2024-12-9

[9]
Updates in novel immunotherapeutic strategies for relapsed/refractory AML.

Front Oncol. 2024-12-4

[10]
Acute myeloid leukemia drug-tolerant persister cells survive chemotherapy by transiently increasing plasma membrane rigidity, that also increases their sensitivity to immune cell killing.

Haematologica. 2025-4-1

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