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The origin and spread of human leukemia
1Division of Hematologic Oncology, Roswell Park Cancer Institute, Buffalo, New York 14263.
Medical Hypotheses
|September 1, 1992
Summary
Human leukemias, including acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL), may not originate from a single stem cell. Instead, endosteal cells might be involved, suggesting a non-clonal origin for these hematologic neoplasms.
Area of Science:
- Hematology
- Oncology
- Cell Biology
Background:
- Human leukemias are hematologic neoplasms characterized by uncontrolled cell proliferation.
- The exact origin and cause of human leukemias remain unknown.
- Leukemias are generally considered clonal diseases originating from a single hematopoietic stem cell.
Purpose of the Study:
- To investigate the cellular origin of human leukemias.
- To challenge the prevailing clonal hypothesis of leukemia development.
- To explore alternative models for leukemia pathogenesis.
Main Methods:
- Morphologic studies of bone marrow biopsies (BMB).
- Analysis of thin sections from plastic-embedded bone marrow.
- Examination of patients with acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), chronic granulocytic leukemia (CGL), and chronic lymphocytic leukemia (CLL).
Main Results:
- Morphologic studies suggest human leukemias may not be clonal.
- A large population of endosteal cells appears to be involved in the leukemic process.
- Simultaneous involvement of endosteal cells suggests a potential non-clonal origin.
Conclusions:
- Human leukemias might arise from a broader population of cells, such as endosteal cells, rather than a single stem cell.
- The transformation of endosteal cells could be linked to abnormalities in humoral factors regulating hematopoiesis.
- Leukemias may represent an aberration of hematopoietic regulatory factors, potentially analogous to historical understanding of pernicious anemia.