Abstract:
:Hematopoietic stem cell transplantation (HSCT) is an established treatment for multiple myeloma (MM), a plasma cell malignancy. To identify an improved pretransplant conditioning regimen, we investigated the cytotoxicity of gemcitabine (Gem) and clofarabine (Clo) combinations toward MM cell lines and patient cell samples. A strong synergism of the two nucleoside analogs, when combined at their approximate IC10 concentrations, was observed. This synergism could be partly due to the observed Gem-mediated phosphorylation and activation of deoxycytidine kinase, resulting in enhanced phosphorylation of Gem and Clo. Their cytotoxicity correlated with a robust activation of the DNA damage response pathway. [Gem+Clo] decreased the mitochondrial membrane potential with a concomitant release of proapoptotic factors into the cytoplasm and nucleus and the activation of apoptosis. Exposure of MM cells to [Gem+Clo] also decreased the level of ribosomal RNA (rRNA), which might have resulted in nucleolar stress, as reported previously, and caused a p53-dependent cell death. A reduction by approximately 50% in the cytotoxicity of Gem and Clo was observed in the presence of pifithrin α, a p53 inhibitor. Furthermore, MM cell lines with mutant p53 exhibited greater resistance to Gem and Clo, supporting a role for the p53 protein in these cytotoxic responses. Our results provide a rationale for clinical trials incorporating [Gem+Clo] combinations as part of conditioning therapy for high-risk patients with MM undergoing HSCT.
journal_name
Exp Hematoljournal_title
Experimental hematologyauthors
Valdez BC,Wang G,Murray D,Nieto Y,Li Y,Shah J,Turturro F,Wang M,Weber DM,Champlin RE,Qazilbash MH,Andersson BSdoi
10.1016/j.exphem.2013.04.009subject
Has Abstractpub_date
2013-08-01 00:00:00pages
719-30issue
8eissn
0301-472Xissn
1873-2399pii
S0301-472X(13)00201-4journal_volume
41pub_type
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journal_title:Experimental hematology
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更新日期:1980-01-01 00:00:00
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