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Blood, 1 November 2005, Vol. 106, No. 9, pp. 3134-3141.
Prepublished online as a Blood First Edition Paper on July 26, 2005; DOI 10.1182/blood-2005-03-0972.


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NEOPLASIA

RAS-blocking bisphosphonate zoledronic acid inhibits the abnormal proliferation and differentiation of juvenile myelomonocytic leukemia cells in vitro

Yoshitoshi Ohtsuka, Atsushi Manabe, Hirohide Kawasaki, Daisuke Hasegawa, Yuji Zaike, Sumiko Watanabe, Takakuni Tanizawa, Tatsutoshi Nakahata, and Kohichiro Tsuji

From the Division of Cellular Therapy, Advanced Clinical Research Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan; the Department of Laboratory Medicine, Research Hospital, Institute of Medical Science, University of Tokyo, Tokyo, Japan; the Division of Molecular and Developmental Biology, Institute of Medical Science, University of Tokyo, Tokyo, Japan; the Department of Pediatrics, Hyogo College of Medicine, Nishinomiya, Japan; the Department of Pediatrics, Saint Lukes International Hospital, Tokyo, Japan; the Department of Pediatrics, Tokyo Medical University, Tokyo, Japan; and the Department of Pediatrics, Kyoto University, Kyoto, Japan.

Juvenile myelomonocytic leukemia (JMML) is a clonal myeloproliferative/myelodysplastic disorder of early childhood with a poor prognosis. JMML cells are characterized by hypersensitivity to granulocyte-macrophage colony-stimulating factor (GM-CSF) caused by a continuously activated GM-CSF receptor–retrovirus-associated sequence (RAS) signal transduction pathway through various molecular mechanisms, resulting in spontaneous GM colony formation in vitro. Bisphosphonate zoledronic acid (ZOL), a RAS-blocking compound, suppressed colony formation from bone marrow (BM) cells of 8 patients with JMML and 5 healthy control subjects without and with GM-CSF (10 ng/mL), respectively, in a dose-dependent manner in clonal culture. At 10 µM ZOL, however, spontaneous GM colony formation from JMML BM cells decreased to 3%, but the formation of G colonies containing granulocytes, but no macrophages, was enhanced, whereas 40% of GM colonies were retained and G colony formation was not affected in culture of normal BM cells with GM-CSF. In suspension culture, cytochemical and flow cytometric analyses showed that 10 µM ZOL also inhibited spontaneous proliferation and differentiation along monocyte/macrophage lineage of JMML BM cells but not the development of normal BM cells by GM-CSF. The inhibitory effect of ZOL on JMML cells was confirmed at a single-clone level and observed even at 3 µM. The current result offers a novel approach to therapy in JMML.


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