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Blood, 15 August 2001, Vol. 98, No. 4, pp. 913-924
REVIEW ARTICLE
Signaling pathways activated by daunorubicin
Guy Laurent and
Jean-Pierre Jaffrézou
From the INSERM E9910, Institut Claudius Régaud,
Toulouse, France; and the Service d'Hématologie, Centre
Hospitalier Universitaire Purpan, Toulouse, France.
The anthracycline daunorubicin is widely used in the
treatment of acute nonlymphocytic leukemia. The drug has, of course, been the object of intense basic research, as well as preclinical and
clinical study. As reviewed in this article, evidence stemming from
this research clearly demonstrates that cell response to daunorubicin
is highly regulated by multiple signaling events, including a
sphingomyelinase-initiated sphingomyelin-ceramide pathway,
mitogen-activated kinase and stress-activated protein/c-Jun N-terminal
kinase activation, transcription factors such as nuclear factor B,
as well as the Fas/Fas-ligand system. These pathways are themselves
influenced by a number of lipid products (diacylglycerol, sphingosine-1
phosphate, and glucosyl ceramide), reactive oxygen species, oncogenes
(such as the tumor suppressor gene p53), protein kinases
(protein kinase C and phosphoinositide-3 kinase), and external stimuli
(hematopoietic growth factors and the extracellular matrix). In light
of the complexity and diversity of these observations, a comprehensive
review has been attempted toward the understanding of their individual
implication (and regulation) in daunorubicin-induced signaling.

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