CD45dimCD34+CD38-CD133+ cells function as leukemic stem cells in acute myeloid leukemia

Leukemia stem cells (LSCs) in acute myeloid leukemia (AML) played important roles in development of leukemia, chemotherapeutic drug resistance, and disease relapse and progression. The identification of LSCs and targeting therapies for them has been under investigation. We examined the CD45 dim CD34 + CD38 - CD133 + cells on bone marrow samples of hematologic malignancies and healthy controls using four-color flow cytometry experiments. Interestingly, the CD45 dim CD34 + CD38 - CD133 + cells were highly expressed in bone marrow of patients with AML compared to that of healthy controls (HC). Moreover, the proportions of CD45 dim CD34 + CD38 - CD133 + cells were also examined in diverse hematology malignancies including AML, CML, DLBCL, MM, MDS, HL, ALL and CLL. These cells were prominently detected in BMCs of AML and CML, but rarely in DLBCL, MM, MDS, ALL, CLL and HL. Additionally, the high levels of the CD45 dim CD34 + CD38 - CD133 + cells in AML patients were an independently significant poor risk factor for overall survival and event free survivals. Therefore, our results suggest that CD45 dim CD34 + CD38 - CD133 + cells in AML might have the potential of leukemia stem cells. In addition, this cell population might be a novel therapeutic target for AML.