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Blood, 1 May 2005, Vol. 105, No. 9, pp. 3714-3721. Prepublished online as a Blood First Edition Paper on January 25, 2005; DOI 10.1182/blood-2004-10-4011.
NEOPLASIA
Nanomolar concentration of NSC606985, a camptothecin analog, induces leukemic-cell apoptosis through protein kinase C
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| Abstract |
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(PKC
) with loss of mitochondrial transmembrane potential (
m) and caspase-3 activation. Cotreatment with rottlerin, a PKC
-specific inhibitor, completely blocks NSC606985-induced mitochondrial 
m loss and caspase-3 activation, while the inhibition of caspase-3 by z-DEVD-fluoromethyl ketone (Z-DEVD-fmk) only partially attenuates PKC
activation and apoptosis. These data indicate that NSC606985-induced PKC
activation is an early event upstream to mitochondrial 
m loss and caspase-3 activation, while activated caspase-3 has an amplifying effect on PKC
proteolysis. In addition, NSC606985-induced apoptosis by PKC
also involves caspase-3independent mechanisms. Taken together, our results suggest that NSC606985 is a potential agent for the treatment of AML. | Introduction |
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Camptothecin, an alkaloid isolated from the Chinese tree Camptotheca acuminata, represents a promising new class of anticancer drugs that target the intranuclear enzyme topoisomerase I (topo-I).12 Initial clinical studies of camptothecin were halted because of severe and unpredictable adverse effects. Supported by detailed understanding of their mechanism of action and facilitated by chemical manipulations that have amplified their solubility, camptothecins have advanced to the forefront of several areas of therapeutic and developmental chemotherapy.13 Especially, 2 water-soluble camptothecin analogs were approved by the Food and Drug Administration for clinical application: topotecan as a second-line therapy for ovarian cancer or small-cell lung cancer and irinotecan for the treatment of colorectal carcinoma refractory to 5-fluorouracil or as initial therapy in combination with 5-flurouracil for the treatment of metastatic colorectal cancer.12
The clinical potentials of camptothecin analogs in the treatment of AML were also investigated. In 1996, Rowinsky et al14 reported that topotecan administered as a single agent had a significant antileukemic activity in patients with AML. Recently, topotecan was investigated as a salvage and front-line therapy for AML in combination with etoposide, cytarabine, or cyclophosphamide, and some efficacious results were obtained.15-17 Further development of novel topo-I inhibitors was spurred by the spectrum of potencies of this class of drugs in terms of enzyme inhibition, antiproliferative activity, toxicities, and pharmaceutical properties. For instance, DX-8951f, a water-soluble hexacyclic camptothecin derivative with more potent topo-Iinhibiting action, has been shown to possess better antileukemic activity in severe combined immunodeficient (SCID) mice with AML.18 Potent preclinical antileukemic activity is also observed for OSI-211, a low-clearance, unilamellar liposomal formulation of a water-soluble camptothecin analog lurtotecan.19
In the present study, we report that very low concentrations (nanomolar, nM) of NSC606985, a rarely studied water-soluble camptothecin ester derivative (Figure 1A),20 can induce leukemic cell apoptosis by proteolytic activation of protein kinase C
(PKC
). By using this system, the relationship among PKC
, mitochondrial transmembrane potentials (
m), and caspase-3 activation in apoptosis regulation is also evaluated.
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| Patients, materials, and methods |
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Leukemic cells, including APL cell line NB4 (kindly provided by Dr Michael Lannotte,21 INSERM u-496, Centre G. Hayem, Hospital Saint-Louis, Paris, France), acute myelomonocytic leukemic U937 cell line, and chronic myeloid leukemic K562 cell line (Cell Bank of Shanghai Institutes for Biological Sciences, Shanghai, China), were cultured in RPMI-1640 medium (Sigma, St Louis, MO) supplemented with 10% heat-inactivated fetal calf serum (FCS; HyClone, Logan, UT) in a 5% CO2 95% air humidified atmosphere at 37°C. For experiments, cells were seeded at 2 to 5 x 105 cells/mL and incubated with the indicated concentrations of NSC606985 with or without the PKC
-specific inhibitor rottlerin and caspase-3 inhibitor z-DEVD-fluoromethyl ketone (Z-DEVD-fmk). Etoposide was also used for apoptosis induction in K562 cells. NSC606985 (kindly provided by National Cancer Institute Anticancer Drug Screen standard agent database, Bethesda, MD) was dissolved in double-distilled water as a 25 µM stock solution. Rottlerin (BIOMOL, Plymouth, PA) was prepared in ethanol as 1 mM stock solution and was kept at -80°C. Z-DEVD-fmk (BD Biosciences, San Diego, CA) was dissolved in dimethyl sulfoxide (DMSO) before use. Etoposide (BIOMOL) was also dissolved in DMSO as 20 mM stock solution and kept at -20°C. Cell viability was determined by the trypan-blue exclusion assay, and growth inhibition rate was calculated according to viable cell numbers of treated cells against numbers of untreated cells. For morphologic observation, cells were collected onto slides by cytospin (Shandon, Runcorn, United Kingdom), stained with Wright staining, and examined under light microscope.
Flow cytometric assays for nuclear DNA content distribution, mitochondrial transmembrane potentials, and annexin-V
To assess the distribution of nuclear DNA content, cells were collected, rinsed, and fixed overnight in 70% cold ethanol at -20°C. Then, cells were treated with Tris (tris(hydroxymethyl)aminomethane)HCl buffer (pH 7.4) supplemented with 1% RNase and stained with 50 µg/mL propidium iodide (PI; Sigma). Cell-cycle distribution was determined by flow cytometry (Beckman Coulter, Miami, FL). All data were collected, stored, and analyzed by Multicycle software (Beckman Coulter). The mitochondrial 
m assay was performed as we described previously.22 Briefly, about 106 cells were rinsed with phosphate-buffered saline (PBS) and incubated with 10 µg/mL rhodamine 123 (Rh123; Sigma) at 37°C for 30 minutes. Subsequently, cells were washed with PBS and stained with 50 µg/mL PI. Fluorescent intensities of Rh123, PI, or both were determined by flow cytometry (Beckman Coulter). Annexin-V assay was performed on a flow cytometry (Beckman Coulter) according to instructions provided by the ApoAlert Annexin-V kit (Clontech, Palo Alto, CA).
DNA gel electrophoresis
Appropriate 106 cells were harvested, and pellets were suspended in lysis buffer (0.1 M NaCl, 50 mM Tris-HC1, pH 7.5, 10 mM EDTA (ethylenediaminetetraacetic acid), 0.5% sodium dodecyl sulfate [SDS], 500 µg/mL protease K). After a 30-minute incubation on ice, samples were centrifuged at 14 000g for 30 minutes, and cellular DNA was extracted. The samples were electrophoresed in 2% agarose gel at 100 V in 40 mM Tris-acetate buffer (pH 7.4) and visualized by ethidium bromide staining.
Nuclear and cytoplasmic fractionation
Cells (about 1 x 107) were incubated in 400 µL lysis buffer (10 mM HEPES (N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid), 10 mM KCl, 1.5 mM MgCl2, 0.5 mM DTT (dithiothreitol), pH 7.9) with the supplement of 0.2% Nonidet P-40 (NP-40; [octylphenoxy]polyethoxyethanol) and protease inhibitor cocktail (Sigma) for 1 minute on ice. The lysates were microcentrifuged for 1 minute at 2300g. The supernatants were collected for cytoplasmic protein extracts. Then, the pellets were washed with lysis buffer without NP-40 and resuspended in 150 µL extraction buffer (20 mM HEPES, pH 7.9, 420 mM NaCl, 0.5 mM DTT, 0.2 mM EDTA, and 25% glycerol) and incubated for 20 minutes on ice. The samples were centrifuged at 12 000g for 10 minutes, and the supernatant was collected as nuclear protein extracts.
Western blots
Cells were washed with PBS and lysed with lysis buffer (62.5 mM Tris-HCl, pH 6.8, 100 mM DTT, 2% SDS, 10% glycerol). Cell lysates were centrifuged at 20 000g for 10 minutes at 4°C, and proteins in the supernatants were quantified. Protein extracts were equally loaded to an 8% to 14% SDSpolyacrylamide gel, electrophoresed, and transferred to nitrocellulose membrane (Amersham Bioscience, Buckinghamshire, United Kingdom). The blots were stained with 0.2% Ponceau S red to ensure equal protein loading. After blocking with 5% nonfat milk in PBS, the membranes were probed with anti-PKC
(1:2000, C-20; Santa Cruz Biotech, Santa Cruz, CA), anticleaved caspase-3 (1:1000; Cell Signaling, Beverly, MA), and poly(ADP [adenosine diphosphate]ribose) polymerase (PARP; 1:500, F2; Santa Cruz Biotech), followed by horseradish peroxidase (HRP)linked secondary antibodies (Cell Signaling). The signals were detected by chemiluminescence phototope-HRP kit (Cell Signaling) according to manufacturer's instructions. As necessary, blots were stripped and reprobed with anti
-actin antibody (Oncogene, Fremont, CA) as an internal control. All experiments were repeated 3 times with the similar results.
Patients, erythroid burst-forming unit (BFU-E), and granulocyte-macrophage colony-forming unit (CFU-GM) assay
Bone marrow (BM) was obtained, with informed consent, from 4 patients with AML, including 2 cases of M3, 1 case of M2, and 1 case of M5 AML according to French-American-British classification. Mononuclear cells were aspirated by Ficoll-Paque liquid and suspended in Iscoves modified Dulbecco medium (IMDM; Gibco BRL, Gaithersburg, MD). Viable cells were counted by trypan-blue exclusion, and then they were diluted to a concentration of 2 x 105 cells/mL. Cells were diluted 1:10 in IMDM containing 10% FCS (HyClone, Logan, UT) with or without 25 nM and 50 nM NSC606985 and were plated in 24-well cell culture plates with Methocult GF H4434 (Stem Cell Technologies, Vancouver, BC). Colonies (> 40 cells) were counted after 14 days of incubation at 37°C with 5% CO2 and humidified air. These experiments were approved by the Clinical Investigational Reviewing Board of Shanghai Second Medical University, Shanghai, China.
Statistical analysis
The significance of the difference between groups was determined by the Student t test.
| Results |
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In APL cell line NB4 cells, NSC606985 inhibited cell growth in a time- and concentration-dependent manner (Figure 1B, left), which paralleled to the reduced cell viability (Figure 1B, right). This inhibitory effect was observed at nanomolar concentrations. At 48 hours of treatment, 6.25 nM NSC606985 produced 48.2% ± 2.8% cell death, and 50 nM and 100 nM NSC606985 almost caused all cells to die (Figure 1B, right). Further evidence supported that NSC606985 induced cell death by way of apoptosis. NB4 cells treated with NSC606985 presented profound morphologic changes that were characteristics of apoptosis, such as chromatin condensation and nuclear fragmentation with intact cell membrane (Figure 1C). Analysis of nuclear DNA distribution on flow cytometry showed that NSC606985 induced a time-dependent increase in hypoploid cells (also called sub-G1 cells) as a result of the degradation and subsequent leakage of nuclear DNA from cells, an important indication of cells becoming apoptotic (Figure 1D).23 In agreement with this, treatment with NSC606985 in NB4 cells also induced apoptosis-specific DNA-laddering fragmentation on the agarose gel electrophoresis (Figure 1E). Furthermore, annexin V/PI double stainingbased flow cytometry analysis, the most sensitive and the most specific test for determining apoptotic cells in suspension culture,24 showed that at early phase after 25 nM NSC606985 treatment, annexin-V+/PI- cells were present (Figure 1F). Subsequently, cells underwent secondary necrosis, as evidenced by increased annexin-V+/PI+ cells (Figure 1F, 48 hours) and necrotic celllike morphology (Figure 1C).
NSC606985 produces differential effects in different leukemic cells
The effect of NSC606985 on cell apoptosis was further examined in 2 other myeloid leukemic cells, U937, a cell line from acute myelomonocytic leukemia, and K562, a cell line from t(9,22)carrying chronic myeloid leukemia. Like that in NB4 cells, NSC606985 inhibited the cell growth in both U937 and K562 cells in a time- and concentration-dependent manner (Figure 2A-B). Although 6.25 nM NSC606985 was sufficient for potent proliferation-inhibitory effect in K562 cells (Figure 2D), the compound failed to induce apoptosis in the cell line, even at a high concentration (200 nM), as determined by cell morphologic criteria (Figure 2C), DNA fragmentation (Figure 2D), annexin-V/PI assay, and cellular DNA content distribution assay (data not shown). As described by previous reports,25,26 etoposide at 100 µM could induce apoptosis in K562 cells (Figure 2C-D), indicating that the resistance of K562 cells to NSC606985-induced apoptosis was not due to clonal selection.
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NSC606985 at apoptosis-inducing concentrations induces proteolytic activation of PKC
with mitochondrial transmembrane potential collapse and caspase-3 activation
To elucidate the mechanisms of NSC606985-induced apoptosis, we first determined the effects of NSC606985 on mitochondrial 
m by double staining of PI and Rh123, a lipophilic cation that is taken up by mitochondria in proportion to the 
m.27 As depicted in Figure 3A, untreated living cells were strongly stained by Rh123 with negative PI. When NB4 cells were treated with 25 nM NSC606985 for 12 hours (Figure 3A, top) or U937 cells treated with 50 nM NSC606985 for 36 hours (Figure 3A, bottom), PI-negative but weaker Rh123-stained cells began to appear and subsequently increased. Following mitochondrial 
m collapse, caspase-3 was also activated by NSC606985 as determined by Western blot analysis using specific antibody against active caspase-3 (Figure 3B). Parallel to this, PARP, a substrate of casapse-3, was degraded after NSC606985 treatment (Figure 3B). However, NSC606985 but not etoposide failed to induce mitochondrial 
m collapse (data not shown) and caspase-3 activation/PARP degradation in K562 cells that are insensitive to the agent-induced apoptosis (Figure 3C).
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into a 41-kDa catalytic fragment that persistently activates the kinase,28-30 in NB4 cells and U937 cells (Figure 4A) but not in K562 cells (Figure 3C). This proteolytic effect was clearly observed at 12 and 24 hours after the treatment with NSC606985 in NB4 cells and U937 cells (Figure 4A), respectively. The similar results could also be seen in etoposide-treated K562 cells (Figure 3C). Moreover, the cleavage of PKC
was observed in both cytoplasm and nuclei of NB4 and U937 cells (Figure 4B). PKC
was present in both cytoplasm and the nucleus of untreated U937 cells, while it was undetectable in the cytoplasm of untreated NB4 cells. It appears that the treatment with NSC606985 increased the level of cytoplasmic PKC
in NB4 cells (Figure 4B).
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-specific inhibitor
To determine the role of proteolytic activation of PKC
in NSC606985-induced apoptosis, we treated NB4 and U937 cells with NSC606985 in the presence or absence of rottlerin (1 µM), a specific PKC
inhibitor.31 As showed in Figure 5A, rottlerin significantly inhibited NSC606985-induced proteolytic cleavage of PKC
. In agreement with this effect, the inhibitor also antagonized NSC606985-induced caspase-3 activation, PARP degradation (Figure 5B) and mitochondrial 
m collapse (Figure 5C). Most importantly, rottlerin completely blocked NSC606985-induced apoptosis in both NB4 cells (Figure 5D) and U937 cells (data not shown). These results strongly indicated that NSC606985-induced PKC
activation was an early event upstream to the mitochondrial 
m collapse and caspase-3 activation and was essential for NSC606985-induced apoptosis in NB4 and U937 cells.
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activation and apoptosis, but not mitochondrial transmembrane potential collapse, are partially antagonized by a caspase-3 inhibitor
To understand the role of caspase-3 and possible relationship between caspase-3 activation and PKC
cleavage in NSC606985-induced apoptosis, NB4 cells were treated with NSC606985 in the presence or absence of the cell-permeable caspase-3 inhibitor Z-DEVD-fmk. As showed in Figure 6, Z-DEVD-fmk completely blocked the NSC606985-induced caspase-3 activation (Figure 6A) but only partially inhibited NSC606985-induced proteolytic cleavage of PKC
(Figure 6B) and apoptosis (Figure 6C). Treatment of NB4 cells with 25 nM NSC606985 alone for 12 hours greatly induced cell apoptosis, which was significantly attenuated by the addition of Z-DEVD-fmk (40 µM) 1 hour before NSC606985 treatment, as assessed by the percentage of annexin V+/PI- cells (P < .01, compared with NSC606985 treatment alone; Figure 6C). However, the addition of Z-DEVD-fmk did not significantly affect NSC606985-induced mitochondrial 
m collapse (P > .05, compared with NSC606985 treatment alone; Figure 6D).
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Finally, we determined the effects of NSC606985 on the clonogenic activity of fresh BM cells from 4 patients with AML using CFU-GM and BFU-E assays. As shown in Figure 7A-B, treatment with 25 nM and 50 nM NSC606985 significantly inhibited CFU-GM formation and resulted in a 100% inhibition in case 3 and case 4. Except for case 2 and case 4 patients whose BM cells did not form BFU-E in untreated condition, the BFU-E formation in2 other patients was also significantly inhibited by NSC606985.
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| Discussion |
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It has been well known that a complex cellular signaling network contributes to the regulation of apoptosis. In most cases, a central player in the execution of apoptosis is aspartic aciddirected cysteine proteases called caspases, which are activated by the cell surface death receptor pathway and the mitochondria-initiated pathway,32 the latter inducing the release of proteins such as cytochrome c from the intermembrane space of 
m-collapsed mitochondria.33 Here, we showed that NSC606985-induced apoptosis paralleled to the mitochondrial 
m loss and caspase-3 activation, but caspase-3specific inhibitor only partially attenuated NSC606985-induced apoptosis, indicating that casapse-3 pathway partially contributed to leukemic cell apoptosis induced by NSC606985. PKC
, a ubiquitously expressed member of the novel PKC family, is activated by translocation, tyrosine phosphorylation, or proteolytic cleavage into 41-kDa catalytically active fragment. The isoenzyme enigmatically presents the multifunctional properties and is implicated in the regulation of a variety of cellular processes, including secretion, cell cycle progression, apoptosis, differentiation, and tumor development.34-36 In 1994, Trubiani et al37 reported for the first time that treatment with dexamethasone in thymocytes resulted in a redistribution of PKC to the nucleus and cell apoptosis, indicating a linkage between PKC activation and cell apoptosis. From then on, increasing data supported a direct link between PKC
activation and cell apoptosis induced by diverse agents such as etoposide,30 ara-C,38 taxol,31 and many others.39-41 However, conflicting results have been reported, and the functional significance of PKC
in cell apoptosis has not been clearly defined, as reviewed by Jackson and Foster.36 In the present study, we show that, like that seen in etoposide-treated K562 cells, NSC606985 rapidly induced proteolytic activation of PKC
and subsequently cell apoptosis in NB4 and U937 cells but not in K562 cells. The PKC
-specific inhibitor rottlerin completely attenuated NSC606985-induced apoptosis, suggesting that PKC
played a critical role in NSC606985-induced apoptosis, and the NSC606985-induced PKC
activation was directly linked to NSC606985-induced cell apoptosis (Figure 7C).
It was proposed that PKC
proteolytic activation was completely dependent on caspase-3, based on the observations that inhibition of caspase-3 activity blocked PKC
cleavage and apoptosis induced by ultraviolet radiation,42 oxidative stress,43,44 DNA damage,45 aging neutrophil31 as well as other inducers.32,46 Here, we demonstrated that the blockage of PKC
activity by rottlerin completely blocked NSC606985-induced mitochondrial 
m loss and caspase-3 activation, indicating that PKC
activation was an event upstream to mitochondrial 
m loss and caspase-3 activation. This result was consistent with reports that PKC
directly interacts with mitochondria and alters mitochondrial function for apoptosis induction,47 presumably mediated through amplifying ceramide formation and the ceramide-mediated mitochondrial amplification loop.48 Furthermore, we showed that inhibition of caspase-3 activity by Z-DEVD-fmk only partially attenuated PKC
cleavage and apoptosis without significant alteration in NSC606985-induced mitochondrial 
m loss, supporting the amplifying effect of activated caspase-3 on PKC
cleavage. More important, these results also proposed that in addition to caspase-3, PKC
-mediated apoptosis also involved caspase-3independent mechanisms that remain to be addressed (Figure 7C). It is possibly associated with some potential downstream carriers of PKC
action in the induction of apoptosis such as DNA-dependent protein kinase,49 p38 mitogen-activated protein kinase,50 Rad9,51 and p73
(a structural and functional homolog of the p53 tumor suppressor52).
It has previously been reported that subcellular localization of PKC
affects its apoptosis-inducing effect. DeVries et al53 showed that the import of PKC
into the nucleus was required for the initiation of etoposide-induced apoptosis, while the attachment of PKC
to membrane and translocation to the Golgi complex was required for the ultraviolet- and ceramide-induced apoptosis, respectively.54,55 Here, we showed that NSC606985-induced PKC
cleavage simultaneously occurred in the cytoplasm and nuclei of both NB4 and U937 cells, although PKC
was differentially distributed within these cells. Unlike untreated U937 cells in which PKC
was present in the cytoplasm and nuclei, NB4 cells had undetectable level of cytoplasmic PKC
. Treatment with NSC606985 increases the levels of cytoplasmic PKC
in NB4 cells. Whether differential subcellular distribution of PKC
is related to the cell sensitivity to NSC606985-induced apoptosis and whether the NSC606985-induced increase in cytoplasmic PKC
is translocated from other subcellular compartments remain to be determined. It should be pointed out that a higher level of an anti-PKC
antibody cross-reactive fragment (about 45 kDa), which existed mainly in the cytoplasm and also down-regulated by NSC606985 treatment, could be clearly seen in NB4 cells, while such a protein was weaker in U937 cells (Figure 4). It remains to be clarified whether the fragment may make NB4 cells more susceptible to NSC606985.
Finally, the cause leading to the difference of effects of NSC606985 on NB4 and U937 cells and on K562 cells remains to be investigated. It has been proposed that the strong resistance of K562 cells to apoptosis induction is related to bcr-abl tyrosine kinase, generated by specific chromosome translocation t(9;22).56 Thus, we speculated that the fusion tyrosine kinase also contribute to the failure of K562 cells to NSC606985-induced apoptosis. However, K562 cells were still extremely resistant to NSC606985-induced apoptosis in the presence of STI571 (data not shown), a specific tyrosine kinase inhibitor,57 proposing that the resistance of K562 cells to NSC606985-induced apoptosis was independent of the constant tyrosine-kinase activity in these cells, which is consistent with the recent finding by Bueno-da-Silva et al.58
In summary, the present study demonstrates that NSC606985 at nanomolar concentrations effectively induces leukemic cell apoptosis, decreases cell proliferation, and inhibits the clonogenic activity of hematopoietic progenitor cells from leukemia patients. The NSC606985-induced apoptosis is mainly mediated through the proteolytic activation of PKC
that leads to caspase-3 activation and mitochondrial 
m loss. These results strongly suggest that NSC606985 is a potential new agent for the treatment of leukemia and deserves further preclinical and clinical studies.
| Footnotes |
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Prepublished online as Blood First Edition Paper, January 25, 2005; DOI 10.1182/blood-2004-10-4011.
Supported in part by National Key Program (973) for Basic Research of China (NO2002CB512805), International Collaborative Items of Ministry of Science and Technology of China (2003DF000038), Science and Technology Commission of Shanghai (grants 02DJ14008, 04DZ14901, and 03XD14016), and 100-Talent Program of Chinese Academy of Sciences.
M-G.S., S-M.G, and K-M.D. contributed equally to this work.
The publication costs of this article were defrayed in part by page charge payment. Therefore, and solely to indicate this fact, this article is hereby marked "advertisement" in accordance with 18 U.S.C. section 1734.
Reprints: Guo-Qiang Chen, No. 280, Chong-Qing South Rd, Shanghai 200025, China; e-mail: chengq{at}shsmu.edu.cn.
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W. Liu, M. Guo, Y.-B. Xu, D. Li, Z.-N. Zhou, Y.-L. Wu, Z. Chen, S. C. Kogan, and G.-Q. Chen Induction of tumor arrest and differentiation with prolonged survival by intermittent hypoxia in a mouse model of acute myeloid leukemia Blood, January 15, 2006; 107(2): 698 - 707. [Abstract] [Full Text] [PDF] |
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| Copyright © 2005 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||