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Prepublished online as a Blood First Edition Paper on August 1, 2002; DOI 10.1182/blood-2002-03-0936.
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Blood, 1 December 2002, Vol. 100, No. 12, pp. 4154-4161
NEOPLASIA
Targeted inhibition of FLT3 overcomes the block to myeloid
differentiation in 32Dcl3 cells caused by expression of FLT3/ITD
mutations
Rui Zheng,
Alan D. Friedman, and
Donald Small
From the Departments of Oncology and Pediatrics, Johns
Hopkins University School of Medicine, Baltimore, MD.
Internal tandem duplication (ITD) mutations of the
juxtamembrane domain-coding sequence of the FLT3 gene are found in up
to 34% of patients with acute myeloid leukemia (AML) and are
associated with a poor prognosis. FLT3/ITDs result in constitutive
activation of the tyrosine kinase domain and transform growth
factor-dependent cell lines. FLT3 activation leads to antiapoptotic
and proliferative signals, but little is known about the impact of
FLT3/ITDs on differentiation. This study was designed to investigate
the effect of FLT3/ITD expression on the differentiation of the 32Dcl3
(32D) myeloblastic cell line to neutrophils in response to granulocyte colony-stimulating factor (G-CSF). Expression of FLT3/ITD
completely blocked morphologic differentiation and induction of
myeloperoxidase (MPO), lysozyme, and CCAAT/enhancer-binding protein (C/EBP ) in response to G-CSF. Wild-type FLT3 and
vector-transfected 32D cells were able to differentiate, although the
maturation of FLT3-transfected cells was delayed by FLT3 ligand (FL)
stimulation. CEP-701, a potent FLT3 tyrosine kinase inhibitor, overcame
the morphologic block in differentiation caused by FLT3/ITD expression
and allowed G-CSF induction of myeloid maturation markers. These
findings suggest that blocking differentiation may be one of the
mechanisms by which FLT3/ITDs contribute to leukemogenesis. CEP-701 and
other FLT3 inhibitors may be useful for overcoming the block to
differentiation (as well as the block to apoptosis) in the leukemic
cells of patients with AML.

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