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Prepublished online as a Blood First Edition Paper on July 31, 2003; DOI 10.1182/blood-2003-03-0861.

Submitted March 21, 2003
Accepted July 25, 2003
Clonal dominance of chronic myelogenous leukemia is associated with diminished sensitivity to the antiproliferative effects of neutrophil elastase
Frank El Ouriaghli, Elaine M Sloand, Lori Mainwaring, Hiroshi Fujiwara, Keyvan Keyvanfar, J J Melenhorst, Katayoun Rezvani, Giuseppe Sconocchia, Scott Solomon, Nancy Hensel, and A J Barrett*
Hematology Branch, National Heart Blood and Lung Institute, National Institutes of Health, Bethesda, MD, USA
* Corresponding author; email: barrettj{at}nih.gov.
Clinical observations suggest that in chronic myelogenous leukemia (CML) the Ph+ clone has a growth advantage over normal hematopoiesis. Patients with CML have high levels of neutrophil elastase, which has recently been shown to antagonize the action of G-CSF and other growth factors. We therefore compared the effect of elastase on the growth of normal and CML progenitor cells. In 10 day suspension cultures of normal or CML CD34+ cells supplemented with G-CSF, SCF and GM-CSF, CML cells had diminished sensitivity to the growth inhibitory effect of elastase. When equal numbers of CML and normal CD34+ cells were co-cultured for 10 days, there was no change in the relative proportions of normal and leukemic cells (measured by FISH or Flow). However when elastase was added, CML cells predominated at the end of the culture period (78 vs 22% with 1µg/mL, and 80 vs 20% with 5µg/mL elastase). CML neutrophils substituted effectively for elastase in suppressing proliferation of normal CD34+ cells, but this effect was abrogated by serine protease inhibitors. These results suggest that elastase overproduction by the leukemic clone can change the growth environment by digestion of growth factors thereby giving advantage to Ph+ hematopoiesis.

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