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I would like to thank Drs Vonderheid and Matsui for their comments and thoughts regarding the concept of lymphoma stem cells in CTCL. In fact, many of the points that they make support rather than contradict the hypothesis of neoplastic stem cells.

In essence, the stem cell hypothesis assumes (1) that lymphomas (and probably most solid tumors) are built mainly of tumor cells that emerge as a result of differentiation from a smaller population of abnormal precursor cells and (2) that these precursor cells do not necessarily reside in the same anatomical site as the main tumor. Keeping these assumptions in mind, let’s walk through Drs Vonderheid and Matsui’s comments:

1. Composite lymphomas can be explained by a simultaneous oncogenic mutation in 2 cell types.

Although this explanation is theoretically possible, the stem cell hypothesis offers a much simpler explanation. Oncogenesis is a process that involves mutations in . . . [Full Text of this Article]

AUTHOR INFORMATION
Robert Gniadecki, MD, DMS

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