Identification of pre-leukemic hematopoietic stem cells in acute leukemia

In acute myeloid leukemia (AML), the cell of origin, nature and biological consequences of initiating lesions and order of subsequent mutations remain poorly understood, as AML is typically diagnosed without observation of a pre-leukemic phase. Here, highly purified hematopoietic stem cells (HSC), p...

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Veröffentlicht in:Nature (London) 2014-02, Vol.506 (7488), p.328-333
Hauptverfasser: Shlush, Liran I., Zandi, Sasan, Mitchell, Amanda, Chen, Weihsu Claire, Brandwein, Joseph M., Gupta, Vikas, Kennedy, James A., Schimmer, Aaron D., Schuh, Andre C., Yee, Karen W., McLeod, Jessica L., Doedens, Monica, Medeiros, Jessie J.F., Marke, Rene, Kim, Hyeoung Joon, Lee, Kwon, McPherson, John D., Hudson, Thomas J., Brown, Andrew M.K., Trinh, Quang M., Stein, Lincoln D., Minden, Mark D., Wang, Jean C.Y., Dick, John E.
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container_end_page 333
container_issue 7488
container_start_page 328
container_title Nature (London)
container_volume 506
creator Shlush, Liran I.
Zandi, Sasan
Mitchell, Amanda
Chen, Weihsu Claire
Brandwein, Joseph M.
Gupta, Vikas
Kennedy, James A.
Schimmer, Aaron D.
Schuh, Andre C.
Yee, Karen W.
McLeod, Jessica L.
Doedens, Monica
Medeiros, Jessie J.F.
Marke, Rene
Kim, Hyeoung Joon
Lee, Kwon
McPherson, John D.
Hudson, Thomas J.
Brown, Andrew M.K.
Trinh, Quang M.
Stein, Lincoln D.
Minden, Mark D.
Wang, Jean C.Y.
Dick, John E.
description In acute myeloid leukemia (AML), the cell of origin, nature and biological consequences of initiating lesions and order of subsequent mutations remain poorly understood, as AML is typically diagnosed without observation of a pre-leukemic phase. Here, highly purified hematopoietic stem cells (HSC), progenitor and mature cell fractions from the blood of AML patients were found to contain recurrent DNMT3a mutations ( DNMT3a mut ) at high allele frequency, but without coincident NPM1 mutations ( NPM1c ) present in AML blasts. DNMT3a mut -bearing HSC exhibited multilineage repopulation advantage over non-mutated HSC in xenografts, establishing their identity as pre-leukemic-HSC (preL-HSC). preL-HSC were found in remission samples indicating that they survive chemotherapy. Thus DNMT3a mut arises early in AML evolution, likely in HSC, leading to a clonally expanded pool of preL-HSC from which AML evolves. Our findings provide a paradigm for the detection and treatment of pre-leukemic clones before the acquisition of additional genetic lesions engenders greater therapeutic resistance.
doi_str_mv 10.1038/nature13038
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title Identification of pre-leukemic hematopoietic stem cells in acute leukemia
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