靶向骨髓微环境治疗急性白血病的研究进展

Research progress on targeting bone marrow microenvironment in acute leukemia therapy

急性白血病（AL）是一类起源于白血病干细胞（LSC）的恶性克隆性疾病，且死亡率高。尽管联合化疗和造血干细胞移植明显改善了AL患者的完全缓解率和总体生存期，但耐药和复发仍是治疗的难题。越来越多的研究表明，白血病耐药和复发的原因之一是骨髓微环境对LSC的保护作用，LSC隐蔽在骨髓微环境中从而逃避化疗药物的杀伤，并在骨髓微环境内自我更新，还可通过改变骨髓微环境而促进AL的发展。因此，通过靶向调控骨髓微环境与LSC间的相互作用，有望找到治疗AL的新方法。

Acute leukemia （AL） is a kind of malignant clonal disease initiated by leukemia stem cells （LSC） with a high mortality. Although combined chemotherapy and hematopoietic stem cell transplantation significantly improved the complete remission rate and overall survival in AL patients, chemoresistance and relapse are still great challenges. Recently, increasing results of studies showed that LSC protected by bone marrow microenvironment was responsible in part of for AL relapse and chemoresistance. LSC hide in the bone marrow microenvironment to escape the killing of chemotherapy drugs and remain self-renewal ability. Furthermore,LSC also promote leukemogenesis by modulating the bone marrow microenvironment. Taken together,targeting the interaction between bone marrow microenvironment and LSC may provide a new promising and novel therapeutic strategies for curing AL.