Microambiente medular en la leucemia mieloide crónica: su relación con la enfermedad y la respuesta al tratamiento.
Palabras clave:
chronic myeloid leukemia, microenvironment, mesenchymal stromal cells, tyrosine kinase inhibitors.Resumen
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm related to the presence of the BCR/ABL fusion gene t(9;22)(q34;q11). This entity is originated from an abnormal pluripotent hematopoietic stem cell, which is characterized as its normal counterparts by long-term self-renewal and multi-lineage differentiation. Both Leukemic and quiescence normal hematopoietic stem cells preferentially reside in the osteoblastic niche and mesenchymal stromal cells (MSC) are located near them and play a critical role in their regulation. Currently, with the tyrosine kinase inhibitors (TKI) therapy, long term clinical responses are achieved in most cases of CML. However, long term treatment failures late could be seen in the context of persistence of leukemic stem cells. The interactions between the leukemic stem cell and the microenvironment could be responsible in part of these events. Here, we briefly review the interactions between the leukemic stem cell and BM stroma and its potential clinical and therapeutic implications.
