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Cancer's unusual suspects

Jonathan Wood

The standard treatment for acute myeloid leukaemia, the most common type of leukaemia in adults, is chemotherapy. But in some people the cancer of the white blood cells can come back after initially successful treatment.

This is thought to be because some cancer stem cells – key cells able to drive the growth of cancers – have remained even after the chemotherapy.

Understanding more about the cancer stem cells present in leukaemia patients could help improve the ability of treatments to get rid of these cancer-driving cells.

Dr Paresh Vyas of the Weatherall Institute for Molecular Medicine at Oxford University and colleagues published a study in Cancer Cell last month that sheds new light on the different populations of stem cells present in leukaemia patients.

The work, funded by the MRC and the Oxford Biomedical Research Centre, could lead to tests that are able to track the presence of cancer stem cells in leukaemia patients, to monitor the progress of treatment or with the aim of preventing later relapse. We caught up with Paresh to learn more...

OxSciBlog: What are cancer stem cells and why are they important?
Paresh Vyas:
Stem cells, in general, are primitive cells capable of continually renewing and producing many different types of cell in the body.

Cancer stem cells in particular are primitive cells that are thought to be the source of a cancer. Consequently lots of efforts are being made to characterise cancer stem cells in order to develop therapies that kill these cells and provide better treatments that cure more patients with fewer side effects.

OSB: What did you set out to investigate?
PV:
We focused on one cancer called acute myeloid leukaemia. Around 2,200 people in the UK are diagnosed with this cancer every year. Unfortunately up to half of these patients relapse and the disease is very difficult to treat if it returns.

We set out to identify the leukaemic stem cells in acute myeloid leukaemia by studying bone marrow samples (the body’s factory for blood cells) from patients with the condition.

OSB: What did you find about leukaemia stem cells?
PV:
We showed that the majority of patients had more than one type of stem-cell-like leukaemia cell in their bone marrow.

OSB: Does this tell us about how leukaemia arises or how the cancer persists?
PV:
The confirmation that a single patient can have more than one type of cancerous stem cell driving the disease may explain why treatments for acute myeloid leukaemia are not effective in many cases.

OSB: Can we make use of this knowledge, either in treating patients or in coming up with new therapies?
PV:
By identifying new cells that are responsible for driving this leukaemia, we can start to develop new and improved treatments that target these cells.

Most significantly for patients with acute myeloid leukaemia, we can also look at better ways of tracking the disease in individuals and preventing the disease returning.