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Prepublished online as a Blood First Edition Paper on January 16, 2003; DOI 10.1182/blood-2002-08-2512.
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Blood, 15 May 2003, Vol. 101, No. 10, pp. 4098-4104
NEOPLASIA
Free radical stress in chronic lymphocytic leukemia cells and its
role in cellular sensitivity to ROS-generating anticancer
agents
Yan Zhou,
Elizabeth O. Hileman,
William Plunkett,
Michael J. Keating, and
Peng Huang
From the Departments of Molecular Pathology,
Experimental Therapeutics, and Leukemia, The University of Texas
M. D. Anderson Cancer Center, Houston, TX.
2-Methoxyestradiol (2-ME), a new anticancer agent currently in
clinical trials, has been demonstrated to inhibit superoxide dismutase
(SOD) and to induce apoptosis in leukemia cells through a free
radical-mediated mechanism. Because the accumulation of superoxide
(O2 ) by inhibition of SOD depends on the
cellular generation of O2 , we hypothesized
that the endogenous production of superoxide may be a critical factor
that affects the antileukemia activity of 2-ME. In the present study,
we investigated the relationship between cellular
O2 contents and the cytotoxic activity of
2-ME in primary leukemia cells from 50 patients with chronic
lymphocytic leukemia (CLL). Quantitation of
O2 revealed that the basal cellular
O2 contents are heterogeneous among patients
with CLL. The O2 levels were significantly
higher in CLL cells from patients with prior chemotherapy. CLL cells
with higher basal O2 contents were more
sensitive to 2-ME in vitro than those with lower
O2 contents. There was a significant
correlation between the 2-ME-induced O2
increase and the loss of cell viability. Importantly, addition of
arsenic trioxide, a compound capable of causing reactive oxygen species
(ROS) generation, significantly enhanced the activity of 2-ME, even in
the CLL cells that were resistant to 2-ME alone. These results suggest
that the cellular generation of O2 plays an
important role in the cytotoxic action of 2-ME and that it is possible
to use exogenous ROS-producing agents such as arsenic trioxide in
combination with 2-ME to enhance the antileukemia activity and to
overcome drug resistance. Such a combination strategy may have
potential clinical applications.

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