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Blood, 1 September 2004, Vol. 104, No. 5, pp. 1465-1473.
Prepublished online as a Blood First Edition Paper on May 13, 2004; DOI 10.1182/blood-2003-11-4039.
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NEOPLASIA
Apoptotic resistance to ionizing radiation in pediatric B-precursor acute lymphoblastic leukemia frequently involves increased NF- B survival pathway signaling
Victoria J. Weston,
Belinda Austen,
Wenbin Wei,
Eliot Marston,
Azra Alvi,
Sarah Lawson,
Philip J. Darbyshire,
Mike Griffiths,
Frank Hill,
Jill R. Mann,
Paul A. H. Moss,
A. Malcolm R. Taylor, and
Tatjana Stankovic
From the Cancer Research UK Institute for Cancer Studies, Birmingham University, Edgbaston, United Kingdom; Department of Haematology, Birmingham Children's Hospital, Birmingham, United Kingdom; and West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Edgbaston, United Kingdom.
To investigate possible causes of the variable response to treatment in pediatric B-precursor acute lymphoblastic leukemia (ALL) and to establish potential novel therapeutic targets, we used ionizing radiation (IR) exposure as a model of DNA damage formation to identify tumors with resistance to p53-dependent apoptosis. Twenty-one of 40 ALL tumors responded normally to IR, exhibiting accumulation of p53 and p21 proteins and cleavage of caspases 3, 7, and 9 and of PARP1. Nineteen tumors exhibited apoptotic resistance and lacked PARP1 and caspase cleavage; although 15 of these tumors had normal accumulation of p53 and p21 proteins, examples exhibited abnormal expression of TRAF5, TRAF6, and cIAP1 after IR, suggesting increased NF- B prosurvival signaling as the mechanism of apoptotic resistance. The presence of a hyperactive PARP1 mutation in one tumor was consistent with such increased NF- B activity. PARP1 inhibition restored p53-dependent apoptosis after IR in these leukemias by reducing NF- B DNA binding and transcriptional activity. In the remaining 4 ALL tumors, apoptotic resistance was associated with a TP53 mutation or with defective activation of p53. We conclude that increased NF- B prosurvival signaling is a frequent mechanism by which B-precursor ALL tumors develop apoptotic resistance to IR and that PARP1 inhibition may improve the DNA damage response of these leukemias.

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