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Biology of Stem and Myeloid Progenitor Cells in Myelodysplastic Syndromes

  • Lambert F. R. Span
  • Theo M. de Witte
Part of the Cancer Treatment and Research book series (CTAR, volume 108)

Abstract

The myelodysplastic syndromes (MDS) are hyperproliferative, acquired clonal stem cell disorders, associated with massive intramedullary apoptosis or programmed cell death (PCD). A leukemic phenotype, mainly characterized by an increase of blasts showing differentiation arrest, is gradually observed, as MDS progresses from low-risk (LR-MDS) to high-risk MDS (HR-MDS). Three interacting compartments can be distinguished in MDS, the polyclonal, residual normal hematopoiesis, the monoclonal preleukemic compartment, and the blastic leukemic compaitnient. Within LRMDS, monoclonal hematopoiesis dominates leukemic blast cell proliferation (<5%), whereas this pattern is reversing during MDS evolution to acute myeloid leukemia (AML). This shift in the balance of proliferation versus apoptosis has to be applied constantly to these three interacting compartments in MDS. For illustration, the following example and nomenclature is used. Stem Cell Factor (SCF) is a major factor to induce differentiation and to mediate the transition from the earliest CD34 negative (CD34−) stem cells to the more differentiated CD34 positive (CD34+) stem cells, whereas IL-6 promotes proliferation and maintains self-renewal of CD34+ stem cells. The balance and interaction between these cytokines may play different roles in normal, monoclonal, and leukemic hematopoiesis(“static profile” of these compartments).

Keywords

Acute Myeloid Leukemia Myelodysplastic Syndrome Stem Cell Factor FasL Expression Leukemic Clone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Lambert F. R. Span
    • 1
  • Theo M. de Witte
    • 1
  1. 1.Department of HematologyUniversity Medical Center NijmegenNijmegenThe Netherlands

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