Microsatellite instability in hematological malignancies: Hypermutation vs. immune control—who is challenging who?

The genome of colorectal carcinomas displaying pronounced microsatellite instability codes for an extraordinarily high number of mutated proteins that elicit tumor-specific cellular immune responses. We have recently demonstrated that leukemic cells are also vulnerable to T cells specific for tumor-associated antigens produced in the context of microsatellite instability. This finding extends our understanding of secondary and therapy-related leukemogenesis, linking it to the mutual interaction between immune control and escape.