Rola szlaków molekularnych i mikrośrodowiska w patogenezie i progresji białaczek

Leukemias are a heterogeneous group of hematologic malignancies characterized by clonal proliferation of bone marrow progenitor cells and classified into acute and chronic, which differ in their biology, epidemiology, and clinical course. Leukemias are currently the most common type of childhood cancer. Biochemically, leukemia involves genetic alterations, metabolic dysregulation, and microenvironmental interactions. Genomic alterations in leukemic cells result from chromosomal translocations, point mutations in oncogenes and tumor suppressors as well as epigenetic modifications. Such changes may affect cell survival and differentiation programs. Additionally, the dysregulation of key signaling pathways contributes to redox homeostasis and fosters survival under oxidative stress conditions. Leukemic cells often exhibit metabolic reprogramming towards enhanced glycolysis and altered amino acid metabolism to support rapid proliferation, whereas the leukemic bone marrow niche provides crucial survival signals through stromal interactions and cytokine secretion, promoting chemoresistance and leukemic adaptation to microenvironmental constraints. Despite the dynamic progress in research and the increasing efficacy of selected therapeutic modalities, disease relapse and treatment resistance remain major challenges. Due to the heterogeneity of leukemias and the resulting diversity of molecular mechanisms, this study presents selected aspects useful for understanding the complexity of their pathogenesis and clinical course. A comprehensive analysis of features characteristic of this group of malignancies, combined with a multidisciplinary approach, contributes to a deeper insight into leukemia biochemistry and facilitates the identification of potential targets for modern therapeutic strategies.