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Dr. John Dick, a senior scientist at Princess Margaret Cancer Centre in Toronto, is shown in a handout photo.

TORONTO Canadian researchers have discovered a pre-leukemic stem cell that may be at the root of acute myeloid leukemia and also be the bad actor that evades chemotherapy and triggers a relapse in patients who have gone into remission.

Acute myeloid leukemia, or AML, is a rapidly progressing cancer of the blood and bone marrow that affects myeloid cells, which normally develop into mature red and white blood cells and platelets.

Leukemia develops when blood stem cells in the bone marrow make abnormal blood cells, which over time crowd out normal blood cells, affecting their ability to function as they should.

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In a paper published online Wednesday in the journal Nature, researchers led by John Dick of Princess Margaret Cancer Centre in Toronto report on the discovery of a pre-leukemic stem cell the forerunner to leukemia stem cells that give rise to the disease.

A leukemia stem cell can lie dormant and theyre the ones that will sustain the growth of the leukemia, Dick said in an interview. The pre-leukemic guys are basically the ancestors that are on their way to becoming leukemia and becoming leukemic stem cells.

Dicks lab was the first to identify the existence of leukemia stem cells, in 1994, followed by the discovery of colon cancer stem cells in 2007.

Teasing out pre-leukemic stem cells from the blood of AML patients based on samples taken at diagnosis, after chemotherapy-induced remission, and then following recurrence advances the understanding of the genetic changes a normal cell has to go through before it turns into AML.

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Scientists discover pre-leukemic stem cell at root of cancer