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Blood, 15 March 2006, Vol. 107, No. 6, pp. 2501-2506.
Prepublished online as a Blood First Edition Paper on November 15, 2005; DOI 10.1182/blood-2005-07-2966.


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NEOPLASIA

Adaphostin-induced oxidative stress overcomes BCR/ABL mutation-dependent and -independent imatinib resistance

Joya Chandra, Jeannette Tracy, David Loegering, Karen Flatten, Srdan Verstovsek, Miloslav Beran, Mercedes Gorre, Zeev Estrov, Nicholas Donato, Moshe Talpaz, Charles Sawyers, Kapil Bhalla, Judith Karp, Edward Sausville, and Scott H. Kaufmann

From the Departments of Pediatrics Research, Experimental Therapeutics and Leukemia, M.D. Anderson Cancer Center, Houston, TX; the Divisions of Oncology Research and Hematology, Mayo Clinic, Rochester, MN; the Department of Hematology-Oncology, UCLA, Los Angeles, CA; the Interdisciplinary Oncology Program, H. Lee Moffitt Cancer Center, Tampa, FL; the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; and the University of Maryland Marlene and Stewart Greenebaum Cancer Center, Baltimore, MD.

The BCR/ABL kinase has been targeted for the treatment of chronic myelogenous leukemia (CML) by imatinib mesylate. While imatinib has been extremely effective for chronic phase CML, blast crisis CML and Ph+ acute lymphoblastic leukemia (ALL) are often resistant. In particular, mutation of the T315 residue in the bcr/abl activation loop renders cells highly resistant to imatinib and to secondgeneration kinase inhibitors such as BMS-354825 or AMN107. Adaphostin is a tyrphostin that was originally intended to inhibit the BCR/ABL kinase by competing with its peptide substrates. Recent findings have in addition implicated reactive oxygen species (ROS) in the cytotoxic mechanism of adaphostin. In view of this unique mode of action, we examined the effects of adaphostin on numerous imatinib-resistant leukemia models, including imatinib-resistant CML and Ph+ ALL cell lines, cells harboring point mutations in BCR/ABL, and specimens from imatinib-resistant CML patients, using assays for intracellular ROS, apoptosis, and clonogenicity. Every model of imatinib resistance examined remained fully sensitive to adaphostin-induced cell death. Collectively, these data suggest that ROS generation by adaphostin overcomes even the most potent imatinib resistance in CML and Ph+ ALL. (Blood. 2006;107: 2501-2506)


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ROS: double-edged sword for leukemic cells
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