What E-Selectin in the Marrow Could Mean for AML Treatment

Rory Shallis, MD, assistant professor of Medicine at Yale School of Medicine, discusses of the presence of the e-selectin molecule in the bone marrow and how it impacts the marrow microenvironment.

Transcript:

0:07 | A timely subject right now is E-selectin, which is an adhesion molecule that is expressed in blood vessels during periods of inflammation. However, it appears to be expressed in a more protracted fashion among the vessel endothelium in the bone marrow of the microvasculature. E-selectin binds several molecules or ligands that are shown to be present on leukemic cells in the marrow, which leads to further upregulation of the E-selectin within the marrow endothelial [cells], up to 10 times the expected amount.

0:43 | As a result, AML is hypothesized to be creating a protective niche that sequesters [leukemia] cells within the bone marrow and harbors them from some chemotherapies. This has been shown to predict more stubborn disease by way of allowing the activation or upregulation of other pathways that promote leukemic progression and chemotherapy resistance, which is a significant clinical problem since many of our patients with AML will be recommended to receive conventional and curative-intent chemotherapy.