Leukaemia cells do not hide in particular areas of the bone marrow in order to evade chemotherapy, according to unexpected findings from Google Earth style vision of the disease process.
Instead, contrary to popular opinion, the cells are highly and unpredictably dynamic suggesting treatment targeting the bone marrow microenvironment is not likely to be useful.
Dr Edwin Hawkins, from the Walter and Eliza Hall Institute of Medical Research, told the limbic the new findings would help focus research back onto therapies targeting the treatment resistant leukaemia cell.
“The treatment field has been split into two – one targeting the leukaemia cell and the second focusing on safe houses for these cells. Now we can refocus on the cells which didn’t respond to initial treatment,” he said.
The research published in the prestigious Nature journal used intravital microscopy of human T-cell acute lymphoblastic leukaemia (ALL) in a mouse model.
The technique provides time lapse imaging of the disease process before, during and after treatment – substantially increasing the quality and quantity of information compared to traditional, static histological images.
“We were expecting to see this specific interaction between T-ALL cells and the bone marrow microenvironment – ‘safe houses’ for leukaemia cells during treatment.”
“Instead we found the vast majority of leukaemia cells were highly motile and not at all dependent on any particular cell types or structures.”
The cells that survived treatment were observed to move faster than earlier infiltrating cells and were still capable of undergoing division.
Dr Hawkins said the findings suggested that therapies targeting proteins associated with the motility of leukaemia cells could make the cells more susceptible to chemotherapy.
The research also found that ALL cells quickly destroy osteoblasts and their progenitors.
“This process has also been reported in multiple myeloma – leading to altered bone remodeling and osteoporosis. We certainly need to understand how this is happening and find a way to block it,” he said.