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  • 1
    In: Blood, American Society of Hematology, Vol. 106, No. 11 ( 2005-11-16), p. 854-854
    Abstract: There are currently no reports concerning the role of the transporter breast cancer resistance protein (BCRP) in adult acute lymphoblastic leukemia (ALL). The aim of this study was to evaluate the frequency of BCRP expression, its correlation with other MDR-related proteins and their prognostic role in 118 untreated adult ALL patients uniformly treated according to the GIMEMA protocol LAL2000. BCRP protein expression was detected by flow cytometry using the MoAb BXP-34 (Kamiya, WA); results were analyzed according to the KS statistic test (D-value). Detection of BCRP in the cell lines MCF7pcDNA3 and MDA231pcDNA3 showed a D-value of 0.12±0.11 and 0.09±0.06, respectively. In contrast, the cell lines MCF7pcDNA3clone 8 and MDA231pcDNA3clone23 that overexpress BCRP were characterized by a D-value of 0.44±0.21 and 0.33±0.11, respectively. Analysis of primary ALL samples showed a BCRP expression (D-value≥ 0.20) in 86/118 (72.9%) cases, with a mean value of 0.36±0.22 (range 0.00–0.87, median 0.37) in the overall population. BCRP expression resulted associated with age (P=0.054). No significant difference was found with other clinical characteristics. The multidrug resistance associated protein (MRP1) (MoAb MRPm6) resulted expressed in 70.1% of samples (D-value≥ 0.20); the MDR1/Pglycoprotein-170 (MDR1) (MoAb MRK16) was present in 28.2% of cases (D-value≥ 0.05). Samples analyzed for both BCRP and MRP1 expression (115/118) showed a significant correlation (R=0.56; P=0.0001): 15.6% of cases were negative for both proteins, while 61.7% expressed both BCRP and MRP1. BCRP expression did not correlate with MDR1 expression. None of these proteins separately influenced the achievement of complete remission (CR). In contrast, BCRP/MRP1 co-expression was associated (P=0.091) with failure to respond to induction treatment: 31% (18/58) of BCRP+/MRP1+ patients failed to achieve CR, while 84.2% (32/38) of cases negative for only one protein or for both responded to induction treatment. Kaplan-Meier analysis was then performed for event-free survival (EFS): among 99 evaluable patients a significant difference (P=0.03) was observed with a median EFS of 8.4 months (95%CI, 5.63–11.28) in BCRP+ cases (72) compared to BCRP- patients (27) for whom median EFS has not been achieved. Multivariate analysis confirmed the unfavorable prognostic role of BCRP positive cases on EFS (P=0.072;OR1.87, 95% CI, 0.94–3.70). In summary, our study shows that adult ALL frequently express BCRP. In patients treated with the GIMEMA LAL 2000 protocol EFS was unfavorably affected by BCRP expression, while co-expression of MRP1 and BCRP was associated with failure to induction treatment. The expression of these proteins may contribute to explain the overall poor outcome of adult ALL patients, suggesting that therapeutic strategies based on overcoming drug resistance remain an important goal to be pursued.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2005
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    detail.hit.zdb_id: 80069-7
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  • 2
    In: Blood, American Society of Hematology, Vol. 106, No. 11 ( 2005-11-16), p. 4552-4552
    Abstract: Methylation of CpG islands in the 5′ gene region is associated with transcriptional silencing of gene expression. The hypermethylation of tumor suppressor genes has been described in various tumor tissues, as in gastric and pancreatic cancer, as well as in acute myeloid leukemia, suggesting its potential role in tumorigenesis. Among the three members of the Kip/Cip family of cyclin dependent kinase inhibitors (CKI) p21, p27 and p57, little is known of their methylation status in hematological malignancies and contrasting studies have been reported on the role of p21 hypermethylation in the pathogenesis of acute lymphoblastic leukemia (ALL). The aim of our study was to analyze in primary blasts from adult ALL enrolled in the GIMEMA protocols 0496 and LAL2000 the methylation status of p21, defining in addition its protein expression by Western blot using the monoclonal antibody p21-WAF1 (Santa Cruz, CA). Primary samples from 81 untreated ALL patients were processed using a widely accepted method based on bisulfite modification of DNA, followed by the use of methylation-specific PCR assay (MSP). The human lymphoblastic cell lines (Jurkat, RPMI8866 and CEM), the myeloid cell line OCI-AML3 and normal peripheral blood lymphocytes (PBL) from 10 healthy donors were characterized by a consistent p21 promoter unmethylation (negative controls). In contrast, it was weakly methylated in the Raji cell line and strongly methylated in the Rael (Burkitt’s lymphoma) cell line (positive controls). This assay was further validate in vitro by SsI methylase. In the present study we analyzed 54 B-lineage ALLs, 25 T-ALLs and 2 biphenothypic leukemias; the mean WBC value at diagnosis was 125.6x109/L and 20 samples were Philadelphia chromosome positive. 71/81 of patients studied for p21 methylation were evaluated for response: 53 (74.6%) achieved complete remission (CR) after induction therapy, 8 (11.3%) patients were resistance and 10 (14.1%) died during induction therapy. DNA methylation was not observed in any of the adult ALL patients. p21 protein expression was found in OCI-AML3, Raji and RPMI8866 cell lines, while resulted negative in the Jurkat cell line and in normal PBL. Preliminary results obtained in the ALL samples showed that this protein was expressed in 8/29 (27.6%) cases. In summary, we demonstrated in a large number of primary ALL cases studied at presentation that the p21 gene is not methylated in this population and therefore that the status of p21 methylation does not play a role in the pathogenesis of adult ALL.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2005
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 3
    In: Blood, American Society of Hematology, Vol. 106, No. 11 ( 2005-11-16), p. 853-853
    Abstract: The mitogen-activated protein kinase (MAPK) pathway contributes to the proliferative and differentiative control of hematopoietic cells. Extracellular signal-regulated kinase-1/2 (ERK) is one of the members of the MAPK pathway; its constitutive activation (p-ERK) has been found in a broad spectrum of hematological malignancies, particularly in acute myeloid leukemia (AML). A molecular therapeutic approach based on MAPK inhibitors has been therefore attempted. The aim of this study was to assess the expression and the clinical role of p-ERK in adult acute lymphoblastic leukemia (ALL) evaluating, in addition, the in vitro effects of the MEK inhibitor PD98059, used alone or in combination with chemotherapy, on the proliferation and apoptosis of ALL blast cells. Primary samples from 131 uniformly treated de novo patients enrolled in the GIMEMA LAL 2000 protocol were evaluated, using a p-ERK1/2-specific MoAb (clone E10), by Western blot analysis and flow cytometric assay which allowed single cell phospho-protein determination by the Kolmogorov-Smirnov statistic test (D-value). Lymphoid cell lines (Jurkat, CEM, RAJI and RPMI8866), as well as normal PMA-activated PBL expressed p-ERK, whereas resting PBL exhibited minimal levels (D-value & lt;0.10). In clinical ALL samples p-ERK ranged between 0 and 0.83, constitutive activation (D-value ≥ 0.10) was found in 45/131 samples (34.5%) and resulted significantly associated with higher WBC values ( & gt;50x109/L; P=0.0128) and lower RNA-index of G1 phase (P=0.0296). Age, leukemia phenotype and molecular characteristics did not associate with p-ERK expression, while phospho-protein levels, measured as a continuous variable, correlated with failure to achieve CR (P=0.069). According to cell availability, we evaluated the effects of the MEK inhibitor PD98059 at 25μM on 30 fresh ALL samples, cultured in vitro for 24 hours. Eight of them were characterized by constitutive ERK activation, which was efficiently abrogated in 6; however, this effect did not induce cell cycle changes or apoptosis either alone or in combination with chemotherapeutic agents (Ara-C and/or Dexametasone). In summary, our study demonstrated that p-ERK is expressed in one third of adult ALL samples at presentation. Patients with p-ERK expression are characterized by higher leukemic mass, with a trend to induction treatment failure. MEK inhibition by PD98059 is capable of modulating p-ERK in primary ALL cells, though it does not result in cell cycle/apoptotic changes. In conclusion, ERK signaling appears only partially involved in the control of proliferative signals in adult ALL and modulation of additional pathways may result in more effective therapeutic strategies.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2005
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 4
    In: Blood, American Society of Hematology, Vol. 109, No. 12 ( 2007-06-15), p. 5473-5476
    Abstract: Extracellular signal-regulated kinase-1/2 (ERK1/2) is frequently found constitutively activated (p-ERK1/2) in hematopoietic diseases, suggesting a role in leukemogenesis. The aim of this study was to assess the expression and clinical role of p-ERK1/2 in adult acute lymphoblastic leukemia (ALL). In 131 primary samples from adult de novo ALL patients enrolled in the Gruppo Italiano per le Malattie Ematologiche dell'Adulto (GIMEMA) Leucemia Acute Linfoide (LAL) 2000 protocol and evaluated by flow cytometry, constitutive ERK1/2 activation was found in 34.5% of cases; these results were significantly associated with higher white blood cell (WBC) values (P = .013). In a multivariate analysis, p-ERK1/2 expression was an independent predictor of complete remission achievement (P = .027). Effective approaches toward MEK inhibition need to be explored in order to evaluate whether this may represent a new therapeutic strategy for adult ALL patients.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2007
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 5
    In: Blood, American Society of Hematology, Vol. 108, No. 11 ( 2006-11-16), p. 1843-1843
    Abstract: Cyclin-dependent kinase inhibitors (CKI) regulate cell division resulting aberrantly expressed in many types of cancer. Alterations of CKI have been reported in acute leukemia, as the result of gene promoter methylation. Despite the common frequency of these alterations, little has been reported on the role of CKI aberrant protein expression and results are less clear, especially in acute lymphoblastic leukemia (ALL). The aim of this study was to analyze p21, p15 and p16 protein expression and their gene methylation status in primary cells from adult ALL cases enrolled in the LAL2000 GIMEMA protocol. Normal peripheral blood lymphocytes (PBL) and 91 primary samples from untreated ALL patients were evaluated in this study. The p21, p15 and p16 protein expression was analyzed by Western blot using the specifically MoAbs. The CKI gene methylation status was investigated using a widely accepted method based on bisulfite modification of DNA, followed by the use of the methylation-specific PCR assay (MSP). This assay was further validated in vitro by SSI methylase. Normal PBL from 10 healthy donors, as described, did not expressed all CKIs and resulted unmethylated. The p21 expression was found in 28/91 cases (30.8%); in contrast, samples were found constantly unmethylated. The p15 expression was found in 44/85 cases (51.8%) and its gene methylated in 41.7%; a significant correlation was found between absence of protein expression and gene methylation (P=0.040). The p16 resulted never expressed in adult ALL, while its promoter was found methylated in 8/42 cases (19.1%). A significant association (P=0.037) was observed between p21 expression and immunophenotype; in fact, 3/24 (12.5%) T-ALL and 24/65 (36.9%) B-lineage ALL expressed this protein. The p16 methylation was associated with T-ALL (P=0.082). Achievement of CR was not influenced by single protein expression, nor by gene methylation status. However, the co-expression of p15 and p21 was associated with failure to induction treatment; in fact, only 6/67 (9%) of patients co-expressing p15 and p21 achieved CR (P=0.021). In summary, in adult ALL p21 is not methylated and p16 is never found expressed, and CR achievement is adversely affected by the co-expression of p21 and p15. In conclusion, we report that in addition to CKI methylation, aberrant expression of CKI, namely p21 and p15, is associated with poor outcome in adult ALL, suggesting that chemotherapy resistance may be promoted in these cases by cell cycle arrest and/or abnormal survival.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2006
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 6
    In: Blood, American Society of Hematology, Vol. 104, No. 11 ( 2004-11-16), p. 1897-1897
    Abstract: The transporter breast cancer resistance protein (BCRP) is a member of the ATP-binding cassette which has been recently described as a protein involved in the multidrug resistance (MDR) phenotype. There are currently no reports concerning the role of this protein in adult acute lymphoblastic leukemia (ALL). The aim of this study was to evaluate the frequency of BCRP expression, its correlation with other MDR-related proteins and their prognostic role in 93 untreated adult ALL patients enrolled in the GIMEMA protocols LAL 0496 and LAL 2000. BCRP protein expression was detected by flow cytometry using the monoclonal antibody BXP-34 (Kamiya, Seattle, WA) and the analysis was performed by the Kolmogorov-Smirnov (KS) statistic test (D-value). Detection of BCRP in the cell lines MCF7 pcDNA3 and MDA231 pcDNA3 showed a D-value of 0.12 ± 0.11 and 0.09 ± 0.06, respectively (negative controls). In contrast, the cell lines MCF7 pcDNA3 clone 8 and MDA231 pcDNA3 clone 23 overexpressed BCRP with a D-value of 0.44 ± 0.21 and 0.33 ± 0.11, respectively (positive controls). Analysis of primary ALL samples showed a BCRP expression (D-value 〉 0.20) in 70/93 (75.3%) cases, with a mean value of 0.33 ± 0.19 (range 0.00-0.87, median 0.33) in the overall population analyzed. BCRP expression resulted higher (mean 0.34 ± 0.03) in samples from patients with WBC counts ≥100 x 109/L compared to the values (mean 0.26 ± 0.13) found in those with lower WBC counts (P=0.06). No significant difference was found between BCRP expression and the clinical characteristics of the patients. The analysis was then extended to the Multidrug Resistance Associated protein (MRP1) and to the MDR1/P-glycoprotein-170 (MDR1). A D-value ≥0.20 and ≥0.05 was found in 53.4% (39/73) and 30.2% (26/86) of cases, respectively. Samples analyzed for both BCRP and MRP1 expression (73/93) showed a significant correlation (R2 = 0.25; P=0.0001): 12.3% of samples were negative for both proteins, while 43.8% expressed both BCRP and MRP1 proteins. In addition, MRP1 negative samples showed lower BCRP levels (mean 0.30, range 0–0.60) compared to MRP1 positive cases (mean 0.38, range 0–0.87) (P=0.017). BCRP expression did not correlate with MDR1 expression. None of these MDR markers correlated separately with achievement of complete remission (CR). In contrast, BCRP/MRP1 co-expression correlated significantly (P=0.034) with failure to respond to induction treatment: 47.8% (11/23) of BCRP+/MRP1+ patients failed to achieve CR, while 78.4% (29/37) of cases negative for only one protein (BCRP-/MRP1+ or BCRP+/MRP1−) or for both (BCRP-/MRP1-) responded to induction treatment. Multivariate analysis (Backward method) confirmed the unfavorable prognostic role on CR of these two proteins concomitantly expressed (P=0.029; OR 0.27, 95% CI, 0.081–0.87). In conclusion, our study shows that BCRP is expressed in a significant proportion of adult ALL. The co-expression of BCRP and MRP1 plays an unfavorable prognostic role on achievement of CR in ALL. These data suggest that the resistance phenotype may be the result of the combined effects of several transporter proteins involved in the MDR process and therefore detection of all these proteins may better predict clinical response to induction treatment.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2004
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 7
    In: Blood, American Society of Hematology, Vol. 106, No. 11 ( 2005-11-16), p. 3370-3370
    Abstract: In the MAPK module, MEK lies upstream of ERK which is found constitutively activated in a host of human tumors. We already demonstrated the growth inhibitory activity of MEK inhibitors in myeloid cells (JCI 2001, Leukemia 2005). PD0325901 is the latest small-molecule inhibitor of MEK with promising effects at lower concentrations. We tested its activity (0.1–1000 nM) in a broad spectrum of leukemia, melanoma and breast cancer cell lines evaluating changes on cell cycle distribution, apoptosis, protein and gene expression profiles, aiming at defining the molecular signature induced by this MEK inhibitor. Among hematopoietic cell lines, PD0325901 induced a marked growth inhibition in myeloid cells with constitutive ERK activation (IC50=11 and 12 nM for OCI-AML3 and OCI-AML2, respectively). Conversely, relative resistance to PD0325901-mediated growth inhibition (IC50 & gt;1μM) was observed in myeloid cell lines without constitutive ERK activation (U937, KG-1) and in lymphoid cell lines (Raji, Jurkat). Among the solid tumor cell lines, the M14 melanoma was markedly sensitive to PD0325901-induced growth inhibition (IC50=24 nM), even with forced Bcl-2 expression (IC50 ranging from 64 to 200 nM in Bcl-2-overexpressing clones). Conversely, the breast cancer cell lines tested (SKBr3, BT474, MDA-MB-231 and ZR75-1) proved relatively resistant (IC50≥1 μM), regardless of the ERK phosphorylation status. In responsive cells (OCI-AML3, OCI-AML2 and M14), PD0325901 inhibited ERK phosphorylation in a dose-dependent manner, the effect was already evident at 15 min. Cell cycle distribution analysis demonstrated a dramatic dose-dependent decrease in the proliferative compartment in OCI-AML3. Subsequently (48–72 h), PD0325901 induced apoptosis in a dose- and time-dependent fashion, as demonstrated by the increase in the percentage of AnnV+ cells from 6.3%±1.1 (DMSO control) to 15.5%±3.9, 31.5%±2.8 and 45.3%±0.14 (10, 100, and 1000 nM PD0325901, respectively). Gene expression profiling was conducted using AffymetrixTM HG-U133A 2.0 GeneChip® in OCI-AML3 cells exposed to DMSO (control) or PD0325901 at 10nM. Using a p & lt;0.05 and a fold changes ≥ 2.0 cut-off, 16 genes were found to be differentially expressed (3 upregulated and 13 downregulated) after 6h of PD0325901 treatment. These effects were even more pronounced after 24h of treatment and, in addition, at this time other genes turned out to be modulated by PD0325901 treatment (a total of 37 were upregulated, 59 downregulated); PD0325901 induced transcriptional changes mostly in genes responsible for cell growth/proliferation, DNA replication and cell signalling. In conclusion, we found that PD0325901, at nanomolar concentrations, displays a promising growth-inhibitory and pro-apoptotic activity in cells with constitutive ERK activation (particularly myeloid leukemias and melanoma). We demonstrated that the expression gene profile of OCI-AML3 is profoundly altered by PD0325901 treatment, particularly reflecting changes in genes involved in the MEK-dependent regulation of cell cycle, as well as new genes potentially useful candidates for further investigation.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2005
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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