Abstract

Chemo-surveillance was introduced by Liau et al. [1] in 1987, which was an important finding but unfortunately did not attract attention. As previously stated, [2] the evolution of cancer in the case of myeloid dysplastic syndrome (MDS) strongly supported the validity of this hypothesis. The evolution of cancer in MDS is a classic case of cancer evolution triggered by immunological disorders. Immunological disorders caused by infectious agents such as AIDS, HBV, HCV, HPV, or genetic defects such as severe combined immunodeficiency can lead to cancer. However, the breakdown of immuno-surveillance as the cause of cancer is a misconception. The breakdown of immuno-surveillance prompts the patient to produce high levels of Tumor Necrosis Factor (TNF), which is responsible for the destruction of bone marrow stem cells and the loss of endogenous chemo-surveillance chemicals due to vascular hyperpermeability caused by TNF. The breakdown of chemo-surveillance is ultimately responsible for the build-up of progenitor stem cells to evolve into cancer stem cells (CSCs).