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Blood, 1 September 2004, Vol. 104, No. 5, pp. 1465-1473.
Prepublished online as a Blood First Edition Paper on May 13, 2004; DOI 10.1182/blood-2003-11-4039.
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Submitted November 25, 2003
Accepted April 22, 2004
Apoptotic resistance to ionising radiation in paediatric B-precursor acute lymphoblastic leukaemia frequently involves increased NF- B survival pathway signalling
Victoria J Weston*, Belinda Austen, Wenbin Wei, Eliot Marston, Azra Alvi, Sarah Lawson, Philip J Darbyshire, Mike Griffiths, Frank Hill, Jill R Mann, Paul A Moss, A M Taylor, and Tatjana Stankovic
CRUK Institute for Cancer Studies, Birmingham University, Birmingham, United Kingdom
Department of Haematology, Birmingham Children's Hospital, Birmingham, United Kingdom
West Midlands Regional Genetics Laboratory, Birmingham, United Kingdom
* Corresponding author; email: victoriaw{at}cancer.bham.ac.uk.
To investigate possible causes of the variable response to treatment in paediatric B-precursor ALL and establish potential novel therapeutic targets, we used ionising radiation (IR) exposure as a model of DNA damage formation to identify tumours with resistance to p53-dependent apoptosis. 21/40 ALLs responded normally to IR, exhibiting accumulation of p53 and p21 proteins and cleavage of caspases 3, 7 and 9 as well as PARP1. 19 tumours exhibited apoptotic resistance and showed absence of PARP1 and caspase cleavage; while 15 of these had normal p53 and p21 protein accumulation, examples exhibited abnormal expression of TRAF5, TRAF6 and cIAP1 following IR, suggesting increased NF- B pro-survival signalling as the mechanism of apoptotic resistance. The presence of a hyperactive PARP1 mutation in one tumour was consistent with such increased NF- B activity. PARP1 inhibition restored p53-dependent apoptosis following IR in these leukaemias by reducing NF- B DNA binding and transcriptional activity. In the remaining 4 ALLs, apoptotic resistance was associated with either a TP53 mutation or defective activation of p53. We conclude that increased NF- B pro-survival signalling is a frequent mechanism by which B-precursor ALL tumours develop apoptotic resistance to IR and that PARP1 inhibition may improve the DNA damage response of these leukaemias.

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