Clinical relevance of genetic alterations in acute myeloid leukemia in children with Down syndrome

Abstract

Hematopoiesis is the formation of new blood cells, which is a tightly balanced and highly organized process of proliferation, differentiation, maturation and cell survival 1 • This process starts in the yolk sac during embryonic development. As the development of the embryo progresses, blood cell formation continues predominantly in the liver, and after birth the bone marrow takes over the process of hematopoiesis. All types of blood cells develop from a communal pool of self-renewing hematopoietic stem cells (HSC's). In a strictly regulated process, the multipotent HSC's can differentiate into either common myeloid or common lymphoid progenitor cells (Figure 1 ). Lymphoid progenitor cells will have the ability to differentiate and mature into either B-lymphocytes arT-lymphocytes, whereas the myeloid progenitor cells differentiate towards the other white blood cells (leukocytes) such as granulocytes (i.e. neutrophils, basophils and eosinophils), monocytes/ macrophages and mast cells, but also to the red blood cells (erythrocytes) and the platelets (thrombocytes).