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Chemotherapy-Induced Leukemia

Mila Bjelica

PhD Candidate, McMaster University

posted:March 5th, 2019

About 1 in 2 people will be diagnosed with cancer at some point in their life, a shocking statistic. Since the 1940s, chemotherapy has remained the first line of treatment for many cancers. Despite increasing remission rates, the incidence of cancer relapse remains worrisome and a great obstacle to curing cancer.

 

What if the same medicine that is used to treat cancer can also promote cancer relapse?

 

Acute myeloid leukemia (AML) is currently treated with chemotherapeutics which are very effective at inducing remission. Unfortunately, within the next few years these patients often experience AML relapse. Until recently, it was thought that dormant leukemic stem cells (LSC) that evaded chemotherapy effects were responsible for this relapse.

 

Using chemotherapy-treated leukemic mouse models and patient bone marrow samples, Dr. Bhatia’s team at McMaster University has confirmed that chemotherapy can in fact successfully eradicate cells that are characterized as LSCs.

 

What more, they have actually identified that chemotherapy can induce changes in leukemic cells that allow them to camouflage. It was determined that these cells are responsible for the regeneration of leukemia, thus termed leukemic regenerative cells (LRCs). This finding has shown to be more than just an explanation to the mechanism of AML regeneration, it has offered a new therapeutic approach as well.

 

Despite being classified under a single name: AML, this type of leukemia is extremely diverse and differs from case to case. Therefore, finding a therapy that is effective for large set of patients proves to be a challenge. However, the identification of LRCs which have a unique molecular signature that is conserved across genetically different AML types, may prove to be a homogenous target for treating AML. Ultimately, this finding challenges our initial notions of the mechanism of cancer relapse but also open up new pathways for more effective AML therapies.

 

Source:

Boyd, A. L., Aslostovar, L., Reid, J., Ye, W., Tanasijevic, B., Porras, D. P., ... & Xenocostas, A. (2018). Identification of chemotherapy-induced leukemic-regenerating cells reveals a transient vulnerability of human AML recurrence. Cancer cell, 34(3), 483-498.