The MDS stem cells were rare, sat at the top of a hierarchy of MDS cells, could sustain themselves, replenish the other MDS cells, and were the origin of all stable DNA changes and mutations that drove the progression of the disease.
'This is conclusive evidence for the existence of cancer stem cells in myelodysplastic syndromes,' says Dr Woll. 'We have identified a subset of cancer cells, shown that these rare cells are invariably the cells in which the cancer originates, and also are the only cancer-propagating cells in the patients. It is a vitally important step because it suggests that if you want to cure patients, you would need to target and remove these cells at the root of the cancer but that would be sufficient, that would do it.'
The existence of cancer stem cells has already been reported in a number of human cancers, explains Professor Jacobsen, but previous findings have remained controversial since the lab tests used to establish the identity of cancer stem cells have been shown to be unreliable and, in any case, do not reflect the "real situation" in an intact tumour in a patient.
'In our studies we avoided the problem of unreliable lab tests by tracking the origin and development of cancer-driving mutations in MDS patients,' says Professor Jacobsen, who also holds a guest professorship at the Karolinska Institutet.
Dr Woll adds: 'We can't offer patients today new treatments with this knowledge. What it does is give us a target for development of more efficient and cancer stem cell specific therapies to eliminate the cancer.
'We need to understand more about what makes these cancer stem cells unique, what makes them different to all the other cancer cells. If we can find biologic
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