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Prepublished online as a Blood First Edition Paper on October 24, 2002; DOI 10.1182/blood-2002-04-1045.
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Blood, 15 February 2003, Vol. 101, No. 4, pp. 1494-1504
NEOPLASIA
The protein tyrosine kinase inhibitor SU5614 inhibits FLT3 and
induces growth arrest and apoptosis in AML-derived cell lines
expressing a constitutively activated FLT3
Karsten Spiekermann,
Ralf J. Dirschinger,
Ruth Schwab,
Ksenia Bagrintseva,
Florian Faber,
Christian Buske,
Susanne Schnittger,
Louise M. Kelly,
D. Gary Gilliland, and
Wolfgang Hiddemann
From the Department of Medicine III, University
Hospital Grosshadern, Clinical Cooperative Group "Leukemia," GSF
National Research Center for Environment and Health, Munich,
Germany; and Howard Hughes Medical Institute and Brigham
and Women's Hospital, Harvard Institutes of Medicine, Harvard Medical
School, Boston, MA
Activating mutations of the protein tyrosine kinase (PTK) FLT3 can
be found in approximately 30% of patients with acute myeloid leukemia
(AML), thereby representing the most frequent single genetic alteration
in AML. These mutations occur in the juxtamembrane (FLT3 length
mutations; FLT3-LMs) and the second tyrosine kinase domain of FLT3-TKD
and confer interleukin 3 (IL-3)-independent growth to
Ba/F3 cells. In the mouse bone marrow transplantation model, FLT3-LMs
induce a myeloproliferative syndrome stressing their transforming
activity in vivo. In this study, we analyzed the pro-proliferative and
antiapoptotic potential of FLT3 in
FLT3-LM/TKD-mutation-transformed Ba/F3 cells
and AML-derived cell lines. The PTK inhibitor SU5614 has inhibitory
activity for FLT3 and selectively induces growth arrest, apoptosis, and
cell cycle arrest in Ba/F3 and AML cell lines expressing a
constitutively activated FLT3. In addition, the compound reverts the
antiapoptotic and pro-proliferative activity of FLT3 ligand (FL)
in FL-dependent cells. No cytotoxic activity of SU5614 was found
in leukemic cell lines that express a nonactivated FLT3 or no FLT3
protein. At the biochemical level, SU5614 down-regulated the activity
of the hyperphosphorylated FLT3 receptor and its downstream targets,
signal transducer and activator of (STAT) 3, STAT5, and
mitogen-activated protein kinase (MAPK), and the STAT5 target
genes BCL-XL and p21. Our
results show that SU5614 is a PTK inhibitor of FLT3 and has
antiproliferative and proapoptotic activity in AML-derived cell lines
that endogenously express an activated FLT3 receptor. The selective and
potent cytotoxicity of FLT3 PTK inhibitors support a clinical strategy
of targeting FLT3 as a new molecular treatment option for patients with
FLT3-LM/TKD-mutation+ AML.

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