Interação entre células leucêmicas e o estroma da medula óssea e sua relação com a progressão do câncer

Abstract

Nowadays the processes involving tumorigenesis and the relation between tumor cells and their microenvironments have been calling huge interest in scientific research. Several authors have demonstrated that neoplastic cells from leukemic patients interact directly or indirectly with stromal cells, modifying their behavior. The present paper aims to correlate the progression of leukemias to alterations in the interaction between leukemic cells and the stroma, comparing with phenomena described in solid tumors. The methodology is based on integrative review searching for articles in the PubMed database involving tumor progression events in solid and hematopoietic tumors, as well as their relation with the development of resistance to chemotherapeutic drugs. The bidirectional regulation between the bone marrow stroma and leukemic cells occur through an adaptation process that has a greateffect on the hematopoietic stem cell compartment, promoting a phenotype of drug resistance and leukemia progression. Similarly to what is observed in solid tumors, in bone marrow these events are also closely associated with the induction of the epithelial-mesenchymal transition (EMT), an event related to the increase of invasiveness in solid tumors. In bone marrow, EMT promotes changes in stromal cells and hematopoietic precursors and can be considered a factor in leukemogenesis, through the promotion of leukemic cells support and facilitation of disease progression. Although the understanding of these events is not fully complete in hematological tumors, the data obtained in the literature points to the proteins involved in EMT as promising targets for future therapies against leukemias.