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Blood, 1 February 2006, Vol. 107, No. 3, pp. 898-903.
Prepublished online as a Blood First Edition Paper on October 18, 2005; DOI 10.1182/blood-2005-06-2430.
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Submitted June 24, 2005
Accepted September 20, 2005
9- -D-erythrofuranosyladenine (EFA) is an effective salvage agent for methylthioadenosine phosphorylase-selective therapy of T-cell acute lymphoblastic leukemia with L-alanosine
Ayse Batova, Howard Cottam, John Yu, Mitchell B Diccianni, Carlos J Carrera, and Alice L Yu*
Department of Pediatrics / Hematology-Oncology, University of California, San Diego, CA, USA
Department of Medicine, University of California, San Diego, CA, USA
Institute of Cellular & Organismic Biology, Academia Sinica, Taipei, Taiwan; The Genomics Research Center, Academica Sinica, Taipei, Taiwan
Department of Pediatrics / Hematology-Oncology, University of California, San Diego, CA, USA; The Genomics Research Center, Academica Sinica, Taipei, Taiwan
* Corresponding author; email: aliceyu{at}ucsd.edu.
The deficiency of methylthioadenosine phosphorylase (MTAP) in T-ALL and other cancers, while constitutively expressed in normal cells, allows for selective therapy using L-alanosine, an inhibitor of de novo AMP synthesis. We demonstrate that MTAP (-) T-ALL cells obtained at relapse are as sensitive as diagnosis samples to L-alanosine toxicity. The therapeutic index of L-alanosine can be increased by the use of a MTAP substrate which protects MTAP (+) normal cells. Since MTAP substrates, MTA and 5'deoxyadenosine, are prone to toxicities associated with adenosine, we synthesized and evaluated a potentially non-toxic MTAP substrate, 9- -D-erythrofuranosyladenine (EFA). The cytotoxicity of EFA to hematopoietic progenitors BFU-E and CFU-GM was at least 26- to 41- fold less than that of MTA. In addition, EFA selectively rescued MTAP (+) Molt-4 cells from L-alanosine toxicity at 25 µM with negligible toxicity even at 100 µM. As for MTA, significant, albeit incomplete, rescue was achieved at 12.5 µM, but higher concentrations were toxic. EFA at 20 µM rescued primary MTAP (+) T-ALL cells and normal lymphocytes from L-alanosine toxicity. Collectively, these data indicate that EFA is an effective agent for salvaging MTAP (+) cells from L-alanosine toxicity and is superior to MTA due to lower cytotoxicity.

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