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Priming in the treatment of acute myeloid leukemia Volume 18, issue 6, Novembre-Décembre 2012

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Author
Hospices civils de Lyon, centre hospitalier Lyon-Sud, hématologie clinique, pavillon Marcel-Bérard, Bat.1G, France

The origin of relapse in acute myeloid leukemia (AML) is believed to be related to persistence of resistant leukemia stem cells in the bone marrow microenvironment where adhesion confers drug resistance. Priming corresponds to the recrutment of leukemic cells into the cell cycle and their mobilization into the circulation with the aim to render them more sensible to chemotherapy. Different approaches can be used. The priming effect of hematopoietic growth factors on quiescent leukemic cells has therefore been explored and is reviewed here. CXCR4 inhibitors, such as plerixafor, overcome adhesion mediated chemotherapy resistance. The rational for such an approach and the first clinical trials are also presented.