Boggs D R
Blood Cells. 1981;7(2):205-15.
Human leukemias and related diseases appear to be clonal in nature. In certain diseases, the initial cell involved is most likely the totipotential hematopoietic stem cell (HSC), i.e., the stem cell capable of giving rise to all hematopoietic cells, lymphoid as well as myeloid. In other diseases, an HSC of more restricted potentiality may be the primary cell producing the disease but, alternatively, all could arise from the totipotential cell. Cells in the clone are often identifiable by the presence of morphologic or chromosomal abnormalities, but in a given clone all cells may not express the abnormalities. In some but not in all patients who have been studied, residual normal HSC have been detected that are not part of the clone. Our current therapeutic attempts designed to cure at least some of these diseases are based on the concept of "total cell kill.' In order to achieve this goal, the clone of tumor cells must be eradicated. To monitor this attempt and carry out therapy in a more scientific fashion, better means of identifying all cells in the clone are needed. If the disease involves the totipotential HSC, for which we assume there is no precursor cell in postfetal life, then there must be residual, normal HSC or the disease cannot be eradicated in this manner without also eradicating the patient.
人类白血病及相关疾病在本质上似乎是克隆性的。在某些疾病中，最初受累的细胞很可能是全能造血干细胞（HSC），即能够产生所有造血细胞（包括淋巴细胞和髓细胞）的干细胞。在其他疾病中，潜能更有限的造血干细胞可能是引发疾病的主要细胞，但也有可能所有细胞都源自全能细胞。克隆中的细胞通常可通过形态学或染色体异常来识别，但在特定克隆中，并非所有细胞都会表现出这些异常。在部分（但并非所有）接受研究的患者中，已检测到不属于克隆的残余正常造血干细胞。我们目前旨在治愈至少部分此类疾病的治疗尝试基于“全细胞杀灭”的概念。为实现这一目标，必须根除肿瘤细胞克隆。为了监测这一尝试并以更科学的方式进行治疗，需要更好的方法来识别克隆中的所有细胞。如果疾病累及全能造血干细胞（我们假定胎儿期后的生命中不存在其前体细胞），那么必然存在残余的正常造血干细胞，否则不以根除患者为代价，就无法通过这种方式根除疾病。
