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Prepublished online as a Blood First Edition Paper on October 31, 2002; DOI 10.1182/blood-2002-07-2236.
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Blood, 15 March 2003, Vol. 101, No. 6, pp. 2328-2334
NEOPLASIA
Fludarabine uptake mechanisms in B-cell chronic lymphocytic
leukemia
Míriam Molina-Arcas,
Beatriz Bellosillo,
F. Javier Casado,
Emili Montserrat,
Joan Gil,
Dolors Colomer, and
Marçal Pastor-Anglada
From the Departament de Bioquímica i Biologia
Molecular, Universitat de Barcelona, Barcelona, Spain;
Unitat d'Hematopatologia and Servei d'Hematologia, Hospital
Clínic, Institut d'Investigacions Biomèdiques Agusti Pi
i Sunyer (IDIBAPS), Barcelona, Spain; and Departament de
Ciències Fisiològiques II, Campus de Bellvitge, Universitat
de Barcelona, Hospitalet, Spain.
Nucleoside derivatives are currently used in the treatment of
hematologic malignancies. Although intracellular events involved in the
pharmacologic action of these compounds have been extensively studied,
the role of plasma membrane transporters in nucleoside-derived drug
bioavailability and action in leukemia cells has not been comprehensively addressed. We have monitored the amounts of mRNA for
the 5 nucleoside transporter isoforms cloned so far (CNT1, CNT2, CNT3,
ENT1, and ENT2) in several human cell types and in normal human
leukocytes. We then examined the expression patterns of these plasma
membrane proteins in patients with chronic lymphocytic leukemia (CLL)
and correlated them with in vitro fludarabine cytotoxicity. Despite a
huge individual variability in the mRNA amounts for every transporter
gene expressed in CLL cells (CNT2, CNT3, ENT1, and ENT2), no
relationship between mRNA levels and in vitro fludarabine cytotoxicity
was observed. Fludarabine accumulation in CLL cells was mostly, if not
exclusively, mediated by ENT-type transporters whose biologic
activity was clearly correlated with fludarabine cytotoxicity, which
reveals a role of ENT-mediated uptake in drug responsiveness in
patients with CLL.

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