白血病的克隆性演化

Clonal Evolution in Leukemia——Editorial

肿瘤的演化学说提出近40年,已被广泛接受指导肿瘤研究和抗肿瘤治疗。近年来的研究进展表明肿瘤干细胞是肿瘤演化的单位,此文通过探讨白血病干细胞的起源和演化,用进化论和生态学的观点梳理十多年来有关肿瘤和白血病发病机制的研究进展。近年来的临床和实验研究提示了白血病干细胞的两种来源:转化的造血干细胞或祖细胞;初步阐明了白血病干细胞的生成和克隆性演化的机制;发现和证实白血病细胞存在多克隆嵌合式演化模式;同时发现白血病细胞的随机性演化-非继承性细胞变异也加速白血病发展。本文对白血病发生发展的嵌合性和网络性进行了讨论,展望了白血病克隆性演化的研究发展方向。

The theory of evolution of tumor cell population has been established for nearly 40 years. It was widely accepted for research and clinical anti-tumor treatment. Recently, it was suggested that cancer stem ceils are the unit of evolution. Considering recent advances on genesis of tumor and leukemia with ecological and evolutionary views, this article reviews origin and evolution of leukemia stem cells. Over the last few years, clinical and experimental data suggest there are two paths for the origin of leukemia stem cells： from a transformed hematopoietic stem cell or progenitor. The mechanisms of leukemia stem cell formation and clonal evolution were elucidated. Sub-clonai mutations and clonal architectures in leukemia were studied and a mosaic evolution pattern is described. Random evolution or non- inherited mutations of leukemia cells would accelerate the progression of malignant disease. Finally, the mosaic or network mechanism for leukemogenesis is also discussed.