Heterogeneity and evolution in acute myeloid leukemia initiating cells

Little is currently known about the heterogeneity of leukemic initiating cells and how they evolve during AML disease progression. AML exhibits extremely few DNA mutations (an average of 13 per patient); therefore, it is likely that RNA based changes also play crucial roles in the development and progression of AML. We have optimized a method to robustly and cost-effectively perform single cell RNA sequencing on AML initiating cells (CD34+CD38-CD45RA+CD90-Lin-7AAD-). We completed a study on serial diagnosis/relapse samples from five AML patients, which revealed strong evidence of the evolution of RNA based changes in AML initiating cells. Single cell RNA sequencing of acute myeloid leukemia cells from five patients (matched diagnosis and relapse bone marrow samples)