Abstract
Despite significant advancements in therapy, patients diagnosed with acute myeloid leukemia (AML) continue to face poor outcomes, often experiencing relapses even after achieving initial complete remission. The occurrence of relapse is attributed to the inability of conventional treatment to eliminate a specific subset of cells within the bone marrow known as leukemic stem cells (LSCs). These specialized cells exhibit self-renewal capacity and have the ability to proliferate and differentiate into leukemic blasts. The accumulation of multiple genetic mutations in LSCs makes them resistant to standard chemotherapy. Several studies have been conducted to identify the phenotypic characteristics and genetic signatures of LSCs, with the aim of differentiating them from normal hematopoietic stem cells (HSCs). Understanding the role of LSCs in AML treatment resistance has paved the way for the development of targeted and more precise treatments, especially for relapsed AML patients, without affecting the healthy HSCs. This review elaborates on the origin, phenotypic and genotypic characteristics of LSCs, and their role in the biology of AML, with a brief note on therapies targeting LSCs.