Abstract:
:Survival in infants younger than 1 year who have acute lymphoblastic leukemia (ALL) is inferior whether MLL is rearranged (R) or germline (G). MLL translocations confer chemotherapy resistance, and infants experience excess complications. We characterized in vitro sensitivity to the pan-antiapoptotic BCL-2 family inhibitor obatoclax mesylate in diagnostic leukemia cells from 54 infants with ALL/bilineal acute leukemia because of the role of prosurvival BCL-2 proteins in resistance, their imbalanced expression in infant ALL, and evidence of obatoclax activity with a favorable toxicity profile in early adult leukemia trials. Overall, half maximal effective concentrations (EC50s) were lower than 176 nM (the maximal plasma concentration [Cmax] with recommended adult dose) in 76% of samples, whether in MLL-AF4, MLL-ENL, or other MLL-R or MLL-G subsets, and regardless of patients' poor prognostic features. However, MLL status and partner genes correlated with EC50. Combined approaches including flow cytometry, Western blot, obatoclax treatment with death pathway inhibition, microarray analyses, and/or electron microscopy indicated a unique killing mechanism involving apoptosis, necroptosis, and autophagy in MLL-AF4 ALL cell lines and primary MLL-R and MLL-G infant ALL cells. This in vitro obatoclax activity and its multiple killing mechanisms across molecular cytogenetic subsets provide a rationale to incorporate a similarly acting compound into combination strategies to combat infant ALL.
journal_name
Bloodjournal_title
Bloodauthors
Urtishak KA,Edwards AY,Wang LS,Hudome A,Robinson BW,Barrett JS,Cao K,Cory L,Moore JS,Bantly AD,Yu QC,Chen IM,Atlas SR,Willman CL,Kundu M,Carroll AJ,Heerema NA,Devidas M,Hilden JM,Dreyer ZE,Hunger SP,Reaman GH,doi
10.1182/blood-2012-04-425033subject
Has Abstractpub_date
2013-04-04 00:00:00pages
2689-703issue
14eissn
0006-4971issn
1528-0020pii
blood-2012-04-425033journal_volume
121pub_type
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