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BMS72 Cancer development and immune defense notes

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Notes of all the lectures and the group works + the SSA of adoptive cell therapy

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Uploaded on
November 11, 2023
Number of pages
23
Written in
2023/2024
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Class notes
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Annek van der waart
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STEM CELL BIOLOGY
NORMAL HAEMATOPOIESIS
 haematopoiesis = formation of blood in the bone marrow
 hematopoietic stem cell:
o very low numbers
o quiescent  dividing once or twice a year
o present during a full lifetime
o present deep in the bone marrow & divide rarely  protected against mutations




 recognizing blood cell populations:
o CD34+, CD38-, Thy1+, c-Kit+, IL-3R-
o CD38+  after the first division
o antibody conjugated to a fluorochrome
binding a specific marker
o SCs can’t just be identified by cell
surface markers, only populations can
be identified
 specific cell transplantations in mice:
o nucleated cells (effector cells) into
immunodeficient mice  short lifespan
o SCs  all blood lineages (myeloid and
lymphoid) develop after 9 months 
transplantation/reconstitution with 1 cell

,LEUKAEMIA DEVELOPMENT
 disbalance proliferation/differentiation/apoptosis caused by genetic mutations
 >20% undifferentiated cells in the bone marrow
 myeloid vs. lymphoid
 acute (rapid increase) vs. chronic (slower growing disease)
 early days morphological classification  nowadays genetic classification
 symptoms: fatigue, fever, anaemia, swollen lymph nodes, night sweats, pain in joints and
bones, loss of weight, bleeding tendency, enlarged spleen, kidney, and the liver, bone
tenderness  very general complaints
 treatment:
o 2 courses of very intensive chemotherapy + a final course if the patient can take it
o subtype specific treatments (rare)
o mostly allogeneic transplantation, autologous are rarer
 cell of origin:

, o multiple mutations and multiple disrupted pathways needed for leukaemia to arise
o possible in short-term SC if there is a mutation in the self-renewal machine
o mutations in the early SC stay present due to self-renewal potential
 leukaemia cell populations:
o leukemic stem cell (LSC)  quiescent
o leukemic cells  proliferative
o leukemic blasts  proliferative, cause the disease the phenotype since they push
away the normal cells from the bone marrow
o resembles normal population
o can expand but not differentiate
 transplantation models:
o only blasts transplanted into mice  hardly any formation of leukaemia
o LSC  often leukaemia, can arise from 1 cell
o several types not transplantable since they are often dependent on the surrounding
microenvironment
 cell of origin vs. cancer stem cells:
o CD38- = cell of origin, pre-malignant cell where the first mutation takes place
o CD38+ = leukaemia-initiating SC, continuous generation of more differentiated
immature leukaemia blasts  doesn’t imply that it is directly derived from normal
SC, it can also be derived from a more mature cell
o GF independent, disrupted apoptosis, differentiation block

TARGETED THERAPY
 conventional chemotherapy kills fast dividing cells, but LSCs not targeted and they can
persist  targeted therapy for all malignant cells
 studying which mutation comes first, their effect, and targeting them
 very specific, less toxic, and less side effects
 resistance, relevant target required, expensive, not for all patients
 some mutations don’t disappear after cure  pre-LSCs can still persist, but it does not mean
the patient has leukaemia, so they are not treated
 DNMT3A mutation

CLONAL EVOLUTION IN CANCER
MUTATIONS & HAEMATOPOIESIS
 biological routes involved in normal cell growth:
o receptors activated by signalling molecules (GF)  gene messaging, survival,
apoptosis  nucleus
o unbalanced signals  disturbance of growth control  apoptosis activation
o genes mutated in leukaemia:
 GF receptors
 signal transduction molecules
 gene expression regulation: TFs, epigenetic regulators, RNA splicing factors,
chromatin organization
 apoptosis
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