Role of Stem Cell Elements in Chronic Myeloid Leukemia

Context: 

Chronic myeloid leukemia (CML) is believed to occur following the clonal expansion of haematopoietic stem cells and is maintained by expanding clones which have acquired a BCR-ABL fusion gene. The properties of untreated CML stem/progenitor cells correlate with a subsequent response to chemotherapy.

Evidence Acquisition: 

The fifty two significant articles discussing the stem cell in chronic myeloid leukemia from 1996 to 2012 were selected according to the authors’ experience.

Studies have shown that primitive CML cells are less responsive to Tyrosine Kinase Inhibitors (TKIs) and are a reservoir for the relapse of multi drug resistant (MDR).

Following that, minimal residual disease (MRD) measurement aims to detect very small numbers of leukemic cells, below the detection limit of morphology and cytogenetics with molecular techniques for patients in clinical remission.