Leukaemia: a model metastatic disease

Disseminated leukaemia cells share many characteristics with metastasizing solid tumour cells. This Perspective discusses the key molecular processes that facilitate leukaemia metastasis, drawing comparisons with leukocyte trafficking and features of solid tumour invasion. Current and future strategies to target leukaemia metastasis are also discussed. In contrast to solid cancers, which often require genetic modifications and complex cellular reprogramming for effective metastatic dissemination, leukaemic cells uniquely possess the innate ability for migration and invasion. Dedifferentiated, malignant leukocytes retain the benign leukocytes' capacity for cell motility and survival in the circulation, while acquiring the potential for rapid and uncontrolled cell division. For these reasons, leukaemias, although not traditionally considered as metastatic diseases, are in fact models of highly efficient metastatic spread. Accordingly, they are often aggressive and challenging diseases to treat. In this Perspective, we discuss the key molecular processes that facilitate metastasis in a variety of leukaemic subtypes, the clinical significance of leukaemic invasion into specific tissues and the current pipeline of treatments targeting leukaemia metastasis.