Stem Cell Dysfunction as a Key Point in Myelodysplastic Syndrome (MDS)

Abstract

MDS microenvironment is complemented by non-cell autonomous alterations and autonomous expansion in some malignant clone as well which can state that the conceptualization of pre-leukemia has the complexity at the hematopoietic microenvironment in these patients. Moreover, the pre-leukemic/leukemic stem cell (LSC) model proposes a non-genetic mechanism in leukemic process which harmonized with the genetic model associated with epigenetic deregulation, contribute to leukemia heterogeneity. In addition, LSCs are different from leukemia initiating cells which are only defined by their abilities to initiate leukemia but with or without self-renewal ability. In fact our understanding of the complex pathobiology which now is recognized to arise from acquisition of sequential mutation in HSCs generally with non-genetic alterations that can give the impair normal leukocytes function and/or clonal gain additionally and go too fast to abnormality condition.