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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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2002-08-2446v1
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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.

© 2003 by The American Society of Hematology.
 

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