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骨髓微环境在白血病干细胞抵抗中的作用:持久性和选择的途径
Serena Barachini1, Marina Montali1, Irene Sofia Burzi2
1Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Critical reviews in oncology/hematology
|December 16, 2025
概括
慢性髓性白血病 (CML) 的干细胞尽管接受治疗,但仍然存在,导致复发. 骨髓微环境维持这些耐药细胞,建议它作为CML治愈的治疗点.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 细胞生物学 细胞生物学
背景情况:
- 慢性髓性白血病 (CML) 源于BCR::ABL1融合基因,影响骨髓干细胞.
- 氨酸激酶抑制剂 (TKIs) 改善了CML的结果,但治愈仍然很少 (约20%),许多患者出现复发或耐药性.
- 骨髓微环境中的持久性白血病干细胞 (LSC) 与CML复发和TKI耐药性有关.
研究的目的:
- 审查骨髓微环境促进CML中LSC持久性和耐药性的机制.
- 探索针对LSC利基的治疗策略,以改善CML根除.
主要方法:
- 文献综述侧重于骨髓微环境在CML中的作用.
- 分析包括代谢重编程,异常信号和细胞相互作用在内的机制.
- 对潜在的治疗干预措施的见解的综合.
主要成果:
- 骨髓的微环境,特别是树皮前细胞,积极支持LSC的生存和抵抗力.
- 抵抗的机制包括代谢变化,异常的信号通路,以及内的保护性细胞对细胞相互作用.
- 准支持性利基是消除耐药性CML克隆的有希望的策略.
结论:
- 骨髓微环境对于维持耐药性CML干细胞至关重要.
- 破坏白血病干细胞位为实现CML持久缓解和治愈提供了潜在的治疗途径.
- 为了开发有效的CML治疗方法,对LSC-微环境相互作用的进一步研究至关重要.
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