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Blood, 1 June 2005, Vol. 105, No. 11, pp. 4223-4225.
Prepublished online as a Blood First Edition Paper on February 17, 2005; DOI 10.1182/blood-2004-10-3892.


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Submitted October 7, 2004
Accepted January 14, 2005

Asparagine synthetase expression is linked with L-asparaginase resistance in TEL-AML1 negative, but not in TEL-AML1 positive pediatric acute lymphoblastic leukemia

Wendy A Stams, Monique L den Boer*, Amy Holleman, Inge M Appel, H B Beverloo, Elisabeth R van Wering, Gritta E Janka-Schaub, William E Evans, and Rob Pieters

Division of Pediatric Oncology / Hematology, Erasmus MC / University Medical Center Rotterdam / Sophia Children's Hospital, Rotterdam, The Netherlands
Department of Clinical Genetics, Erasmus MC / University Medical Center Rotterdam, Rotterdam, The Netherlands
Dutch Childhood Oncology Group, The Hague, The Netherlands
COALL study group, Hamburg, Germany
Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
Division of Pediatric Oncology / Hematology, Erasmus MC / University Medical Center Rotterdam / Sophia Children's Hospital, Rotterdam, The Netherlands; Dutch Childhood Oncology Group, The Hague, The Netherlands

* Corresponding author; email: m.l.denboer{at}erasmusmc.nl.

Resistance to L-Asparaginase in leukemic cells may be caused by an elevated cellular expression of asparagine synthetase (AS). Previously, we reported that high AS expression did not correlate to L-Asparaginase resistance in TEL-AML1 positive B-lineage ALL. In the present study, we confirmed this finding in TEL-AML1 positive patients (n=28) using microarrays. In contrast, 35 L-Asparaginase resistant TEL-AML1 negative B-lineage ALL patients had a significant 3.5-fold higher AS expression than 43 sensitive patients (p=0.0004). Using RTQ-PCR, this finding was confirmed in an independent group of 39 TEL-AML1 negative B-lineage ALL patients (p=0.03). High expression of AS was associated with poor prognosis (4-yrs pDFS 58% ± 11%) compared to low expression (4-yrs pDFS 83% ± 7%; p=0.009). We conclude that resistance to L-Asparaginase and relapse-risk are associated with high expression of AS in TEL-AML1 negative but not in TEL-AML1 positive B-lineage ALL.


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