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Cancer's ability to evolve and transform poses one of the central challenges to achieving cure. This plasticity results in part from intra-tumoral cellular heterogeneity; the malignant cell population is not monolithic, but rather a collection of competing populations, which, through competition, optimize the cancers’ fitness. Nowell and others formulated the theoretical framework for this process in the 1970s. Since then, experimental support for the theory has been demonstrated with improving technological tools. In recent years, the study of cancer evolution has generated increasing interest as massively parallel sequencing affords unprecedented insight into clonal heterogeneity, as well as the ability to track it over time. Recent landmark studies have defined the clonal texture of different hematological malignancies and their transformation with therapy.
The clonal evolution spotlight series will provide comprehensive reviews on the evolutionary aspects of common hematopoietic malignancies. The reviews will cover key topics including biological principles guiding the evolutionary process, methodological considerations, and importantly, a perspective on applying this knowledge to improve patient care.