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Blood, 1 February 2006, Vol. 107, No. 3, pp. 1156-1165.
Prepublished online as a Blood First Edition Paper on October 13, 2005; DOI 10.1182/blood-2005-05-1989.


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Submitted May 18, 2005
Accepted September 25, 2005

NF-{kappa}B constitutes a potential therapeutic target in high-risk myelodysplastic syndromes

Thorsten Braun, Gabrielle Carvalho, Arnauld Coquelle, Marie-Catherine Vozenin, Pascale Lepelley, Francois Hirsch, Jean-Jacques Kiladjian, Vincent Ribrag, Pierre Fenaux, and Guido Kroemer*

Centre National de la Recherche Scientifique, UMR8125, Institut Gustave Roussy, Villejuif, France
UPRES EA 2710, Institut Gustave Roussy, Villejuif, France
Laboratoire d'Hematologie, Hopital Calmette, Lille, France
INSERM-U542, Paris XI University, Hopital Paul Brousse, Villejuif, France
Service d'Hematologie Clinique, Hopital Avicenne, AP-HP, Universite Paris, Bobigny, France
Service d'Hematologie Clinique, Institut Gustave Roussy, Villejuif, France

* Corresponding author; email: kroemer{at}igr.fr.

MDS is a preneoplastic condition that frequently develops into overt AML. The P39 MDS/AML cell line manifested constitutive NF-{kappa}B-activation. In this cell line, NF-{kappa}B -inhibition by small interfering RNAs specific for p65 or chemical inhibitors including bortezomib resulted in the downregulation of apoptosis-inhibitory NF-{kappa}B target genes and subsequent cell death, accompanied by loss of mitochondrial transmembrane potential as well as by the mitochondrial release of the caspase activator cytochrome c and the caspase-independent death effectors endonuclease G and apoptosis inducing factor (AIF). Bone marrow cells from high-risk MDS patients also exhibited constitutive NF-{kappa}B-activation, similarly as bone marrow samples from MDS-AML patients. Purified hematopoietic stem cells (CD34+) and immature myeloid cells (CD33+) from high-risk MDS patients demonstrated the nuclear translocation of the p65 NF-{kappa}B subunit. The frequency of cells with nuclear p65 correlated with blast counts, apoptosis suppression and disease progression. NF-{kappa}B-activation was confined to those cells that carried MDS-associated cytogenetic alterations. Since NF-{kappa}B-inhibition induced rapid apoptosis of bone marrow cells from high-risk MDS patients, we postulate that NF-{kappa}B-activation is responsible for the progressive suppression of apoptosis affecting differentiating MDS cells and thus contributes to malignant transformation. NF-{kappa}B-inhibition may constitute a novel therapeutic strategy if apoptosis induction of MDS stem cells is the goal.


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