Understanding the interaction between leukemia stem cells and their microenvironment to improve therapeutic approaches.

Overview

Although chemotherapeutic regimens can eliminate blasts in leukemia patients, they are associated with toxicity and often fail to eliminate all malignant cells resulting in disease relapse. Disease relapse has been attributed to the persistence of leukemia cells in the bone marrow (BM) with the capacity to recapitulate disease, these cells are often referred to as leukemia stem cells (LSCs). While LSCs have distinct characteristics in terms of pathobiology and immunophenotype, they are regulated by their interactions with the surrounding microenvironment. Thus, understanding the interaction between LSCs and their microenvironment is critical to identify effective therapies. To this end, there are numerous efforts to develop models to study such interactions. In this review, we will focus on the reciprocal interactions between LSCs and their milieu in the BM. Furthermore, we will highlight relevant therapies targeting these interactions and discuss some of the promising in vitro models designed to mimic such relationship.