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Different pathways within a PHSP are suggested to include subsequent intermediate steps: 1. regulation of aneuploidy; 2. HST/PR; 3. autocatalytic karyotype evolution; 4a. induction of senescence or apoptosis/necroptosis in a majority of hybrid cells that are unable to survive due to uncoordinated HST/PR; 4b. proliferation of new cancer cells, some of which can carry potential stem-cell properties including radio-/chemoresistance.
