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Prepublished online as a Blood First Edition Paper on November 14, 2002; DOI 10.1182/blood-2002-08-2446.
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Blood, 1 April 2003, Vol. 101, No. 7, pp. 2743-2747
NEOPLASIA
Sensitivity to L-asparaginase is not associated with
expression levels of asparagine synthetase in t(12;21)+
pediatric ALL
Wendy A. G. Stams,
Monique L. den Boer,
H. Berna Beverloo,
Jules P. P. Meijerink,
Rolinda L. Stigter,
Elisabeth R. van
Wering,
Gritta E. Janka-Schaub,
Rosalyn Slater, and
Rob Pieters
From the Erasmus MC/University Medical Center
Rotterdam/Sophia Children's Hospital, Division of Pediatric
Oncology/Hematology, Rotterdam, the Netherlands; Erasmus
MC/University Medical Center Rotterdam, Department of Clinical
Genetics, Rotterdam, the Netherlands; Dutch Childhood
Leukemia Study Group, The Hague, the Netherlands;
Cooperative ALL (COALL) Study Group, Hamburg, Germany; and
Erasmus MC/University Medical Center Rotterdam, Department of Cell
Biology and Genetics, Rotterdam, the Netherlands.
The (12;21) translocation resulting in TEL/AML1 gene
fusion is present in about 25% of childhood precursor B-lineage acute lymphoblastic leukemia (ALL) and is associated with a good prognosis and a high cellular sensitivity to L-asparaginase
(L-Asp). ALL cells are thought to be sensitive to
L-Asp due to lower asparagine synthetase (AS) levels.
Resistance to L-Asp may be caused by an elevated cellular
level of AS or by the ability of resistant cells to rapidly induce the
expression of the AS gene on L-Asp exposure. AS may be a target regulated by t(12;21). We studied the
relationship between t(12;21) and the mRNA level of AS to
investigate a possible mechanism underlying L-Asp
sensitivity. Real-time quantitative reverse transcription-polymerase
chain reaction (RT-PCR) analysis surprisingly revealed that 30 patients
positive for t(12;21) expressed 5-fold more AS mRNA
compared with 17 patients negative for t(12;21) (P = .008) and 11 samples from healthy controls
(P = .016). The mRNA levels of AS between
t(12;21) ALL and healthy controls did not differ. No
difference was found between ALL patients positive or negative for
t(12;21) in the capacity to up-regulate AS after in vitro
L-Asp exposure, excluding a defective capacity for t(12;21)
cells in up-regulating AS on L-Asp exposure.
Moreover, no correlation was observed between AS mRNA
expression and sensitivity to L-Asp. We conclude that the
sensitivity of t(12;21)+ childhood ALL to
L-Asp is not associated with the expression level of the
AS gene. Furthermore, we contradict the general thought that leukemic cells specifically lack AS compared with normal bone
marrow and blood cells.

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