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Working hypothesis for induction of an immune response to MDS and the selection of trisomy 8 clones. Trisomy 8 cells over-express normal antigens such as WT1 which results in induction of an immune response. Cytotoxic T cells, which recognize the antigen, expand. However, these cells are ineffective in eliminating the trisomy 8 clone. Apoptosis is triggered in the trisomy 8 cell but is blocked upstream of caspase 8 activation because trisomy 8 cells overexpress survivin.
