Journal of Clinical Oncology, Vol 1, 277-284, Copyright © 1983 by American Society of Clinical Oncology
Functional organization of the hematopoietic stem cell compartment: implications for cancer and its therapy
S Hellman, U Reincke, L Botnick and P Mauch
Recent discoveries indicate that hematopoietic stem cells have limits on
their proliferative capacity and are unable to divide indefinitely. There
is great heterogeneity within the compartment as to the extent of this
proliferative limitation. At any given time it appears that hematopoiesis
is maintained by the progeny of only a few stem cells. When these are
exhausted the progeny from other stem cells take their place. The
observations of proliferative limitation, heterogeneity, and clonal
succession must be incorporated into any model of stem cell organization.
These new discoveries and the models incorporating them have important
clinical implications. They may explain the inability of normal tissues to
develop drug resistance and they also offer a mechanism by which cell
renewal systems decrease the development of malignancies. In the selection
of chemotherapeutic agents not only the effectiveness of the drug upon the
tumor must be considered, but also how specific agents affect the stem cell
compartment. These data have important implications in the use of bone
marrow transplantation for both malignant and nonmalignant disease.
