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. Author manuscript; available in PMC: 2018 Jul 2.
Published in final edited form as: Expert Rev Anticancer Ther. 2017 Jul 5;17(8):725–736. doi: 10.1080/14737140.2017.1347507

Figure 1.

Figure 1

Clonal evolution of relapsed leukemia. 94% of relapsed clones exhibit a clear relationship to the clone seen at diagnosis. Intrinsically drug resistant clones can exist at low levels at diagnosis and survive treatment while other times, the drug resistance may be acquired. The majority of cases reveal a relapsed clone that has directly evolved from the leukemic stem cell. Rarely, the clone seen at relapse is genetically distinct from that at diagnosis and represents a new leukemia. Modified from Mullighan, Science (2008) and Bhatla, J Pediatr Hematol Oncol (2014).