Figure 2.3.2 - Electron micrograph of an animal cell
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The story of progress in the treatment of the leukemias, all considered incurable when I was in college,is described in Cancer 113(7S): 1933, 2008.
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By contrast, CHRONIC LEUKEMIAS ("well-differentiated leukemias") feature cancer cellsthat do mature(more or less), and that have a natural history measured in years.
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Many of these people have a clone of T-cellswith mutated perforin (Blood 109: 5234, 2007), the samelocus that's mutated in familial hemophagocytic lymphohistiocytosis.Other cases of acquired aplastic anemiaseem to be the result of running out of telomere lengthduring aging.
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(It is poorly-named.)In the 1990's, it became clear that most cases of aplastic anemia are causedby T-cell-mediated attacks on the hematopoietic marrow.
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WARNING: The following "myeloproliferative diseases" are all "tumors of the multipotent myeloid stem cell", and can transform into one another (usually from a mild one to a bad one): * "Chronic neutrophilic leukemia / atypical CML" is a different leukemiathat may someday be defined by its being driven by CSF-3R mutations (NEJM 368:1781, 2013).
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Newer therapies (alpha-interferon with or without cytarabine) suppress the leukemic clone and do prolong survival. Historically, the only hope for a cure was allogenic bone marrow transplantation.