Clinical perspectives of concepts on neoplastic stem cells and stem cell-resistance in chronic myeloid leukemia.

Journal: Leukemia & Lymphoma
Published:
Abstract

In chronic myeloid leukemia (CML), neoplastic stem cells and/or their subclones exhibit resistance against BCR/ABL tyrosine kinase inhibitors (TKIs). Therefore, residual CML stem cells (subclones) in TKI-treated patients are a logical target of therapy, and their elimination is considered a major aim and clue in the development of curative treatment approaches. A number of different mechanisms may underly resistance of CML stem cells against TKIs and other targeted or/and conventional drugs, including stem cell quiescence, expression of drug-transporters, stem cell plasticity, BCR/ABL mutations, overexpression of BCR/ABL and BCR/ABL-independent signalling- and survival-molecules. In this article, possibilities to overcome stem cell resistance in CML by exploiting knowledge on molecular mechanisms that underly the 'stem cell escape' from drug therapy are discussed.

Authors
Peter Valent, Michael Deininger