Preleukemia: The normal side of cancer

Liran I. Shlush*, Mark D. Minden

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

23 Citations (Scopus)

Abstract

PURPOSE OF REVIEW: In the present review, we will define the preleukemic state. We aim at increasing awareness and research in the field of preleukemia that will nurture targeted therapy for the earlier steps of leukemia evolution. RECENT FINDINGS: Emerging evidence supports the role of hematopoietic stem/progenitor cells carrying recurrent leukemia-related mutations as the cell of origin of both myeloid and lymphoid malignancies. The preleukemic stem cells can maintain at least to some extent their functionality; however, they have increased fitness endowed by the preleukemic mutations that lead to clonal expansion. SUMMARY: The latent preleukemic period before overt leukemia presents can take years, and the majority of carriers will never develop leukemia in their lifetime. The preleukemic state is not rare, with greater than 1% of individuals having acquired one or more of the recognized preleukemic lesions. The high frequency of such abnormalities in the population may be the cost of growing old; however, another view could be that in order to survive to old age, the hematopoietic system must adapt to create robust hematopoietic stem/progenitor cells with an increased fitness and clonal expansion. Hence, leukemia does not necessarily start as a disease, but rather as a need, with the normally functioning preleukemic hematopoietic stem cells trying to maintain health for years but in time succumbing to their own acquired virtues.

Original languageEnglish
Pages (from-to)77-84
Number of pages8
JournalCurrent Opinion in Hematology
Volume22
Issue number2
DOIs
Publication statusPublished - Mar 2015
Externally publishedYes

Funding

We would like to thank Dr Shalev Itzkovitz and Dr Andre Schue for their helpful discussions. The present work was supported by Postdoctoral Fellowship Award from the McEwen Centre for Regenerative Medicine with funding made available through the Gentle Ben Charity (L.I.S.).

All Science Journal Classification (ASJC) codes

  • Hematology

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