Hematological malignancies: disease pathophysiology of leukemic stem cells

Hematopoietic homeostasis is maintained throughout the lifetime of an individual through self-renewal of hematopoietic stem cells. Defects in the self - renewal and differentiation lead to hematopoietic insufficiency and development of malignancies. Leukemic stem cells (LSCs), which are considered to originate from hematopoietic stem or progenitor cells, not only adopt the regulatory machinery operating in normal HSCs but establish their own mechanisms against apoptosis and senescence. Hematopoietic malignancies are of Lymphoid origin with CLL and ALL and myeloid malignancies with AML and CML and in addition there are disease of the plasma multiple myelomas. One of the major therapeutic strategies for hematological malignancies is hematopoietic stem cell transplantation along with combination of chemotherapy. The review gives an insight of different hematological malignancies, the mechanism and therapeutic strategies available at present.