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Prepublished online as a Blood First Edition Paper on March 13, 2003; DOI 10.1182/blood-2002-08-2369.

Submitted August 2, 2002
Accepted January 16, 2003
Stem cell factor protects erythroid precursor cells from chemotherapeutic agents via upregulation of Bcl-2 family proteins
Ann Zeuner, Francesca Pedini, Michele Signore, Ugo Testa, Elvira Pelosi, Cesare Peschle, and Ruggero De Maria*
Laboratory of Hematology-Oncology, Istituto Superiore di Sanita', Rome, Italy
Department of Experimental Oncology, Istituto Oncologico del Mediterraneo, Catania, Italy
Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
* Corresponding author; email: rdemaria{at}tin.it.
Suppression of red blood cell production is a common complication of chemotherapy, causing anemia in a significant number of cancer patients. We have evaluated the sensitivity of human hematopoietic progenitors and erythroid precursor cells to chemotherapeutic drugs and found that basophilic erythroblasts represent the stage of erythroid differentiation more vulnerable to the cytotoxic effects of myelosuppressive agents. Stem cell factor (SCF) supports proliferation and survival of early hematopoietic cells by binding to the c-kit receptor. In unilineage erythropoietic culture of CD34+ progenitors, short term pretreatment of immature erythroid precursors with SCF results in protection from apoptosis induced by chemotherapeutic agents and restores normal proliferation and differentiation after removal of the cytotoxic stimulus. The levels of drug-induced caspase processing are significantly reduced in erythroblasts treated with SCF, indicating that activation of the c-kit receptor generates anti-apoptotic signals acting before amplification of the caspase cascade. Accordingly, we found that SCF upregulates Bcl-2 and Bcl-XL in erythroid precursors and that exogenous expression of these proteins protects erythroblasts from caspase activation and death induced by chemotherapeutic agents. These results suggest a possible mechanism for SCF-mediated protection of erythroid precursor cells from apoptosis and may contribute to devise new strategies for prevention and treatment of chemotherapy-induced anemia.

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