Dynamics of leukemia stem-like cell extinction in acute promyelocytic leukemia Academic Article uri icon


MeSH Major

  • Leukemia, Promyelocytic, Acute
  • Neoplastic Stem Cells


  • Many tumors are believed to be maintained by a small number of cancer stem-like cells, where cure is thought to require eradication of this cell population. In this study, we investigated the dynamics of acute promyelocytic leukemia (APL) before and during therapy with regard to disease initiation, progression, and therapeutic response. This investigation used a mathematical model of hematopoiesis and a dataset derived from the North American Intergroup Study INT0129. The known phenotypic constraints of APL could be explained by a combination of differentiation blockade of PML-RARĪ±-positive cells and suppression of normal hematopoiesis. All-trans retinoic acid (ATRA) neutralizes the differentiation block and decreases the proliferation rate of leukemic stem cells in vivo. Prolonged ATRA treatment after chemotherapy can cure patients with APL by eliminating the stem-like cell population over the course of approximately one year. To our knowledge, this study offers the first estimate of the average duration of therapy that is required to eliminate stem-like cancer cells from a human tumor, with the potential for the refinement of treatment strategies to better manage human malignancy.

publication date

  • October 2014



  • Academic Article



  • eng

PubMed Central ID

  • PMC4184925

Digital Object Identifier (DOI)

  • 10.1158/0008-5472.CAN-14-1210

PubMed ID

  • 25082816

Additional Document Info

start page

  • 5386

end page

  • 96


  • 74


  • 19