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Blood, 15 March 2006, Vol. 107, No. 6, pp. 2501-2506.
Prepublished online as a Blood First Edition Paper on November 15, 2005; DOI 10.1182/blood-2005-07-2966.
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Submitted July 26, 2005
Accepted November 1, 2005
Adaphostin-induced oxidative stress overcomes bcr/abl mutation-dependent and -independent imatinib resistance
Joya Chandra*, Jeannette Tracy, David Loegering, Karen Flatten, Srdan Verstovsek, Miloslav Beran, Mercedes Gorre, Zeev Estrov, Nicholas Donato, Moshe Talpaz, Charles Sawyers, Kapil Bhalla, Judith Karp, Edward Sausville, and Scott H Kaufmann
Department of Pediatrics Research, M.D. Anderson Cancer Center, Houston, TX, USA
Division of Oncology Research and Hematology, Mayo Clinic, Rochester, MN, USA
Department of Experimental Therapeutics, M.D. Anderson Cancer Center, Houston, TX, USA
Department of Hematology-Oncology, UCLA, Los Angeles, CA, USA
Department of Leukemia, M.D. Anderson Cancer Center, Houston, TX, USA
Department of Interdisciplinary Oncology Program, H. Lee Moffitt Cancer Center, Tampa, FL, USA
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
University of Maryland Marlene and Stewart Greenebaum Cancer Center, Baltimore, MD, USA
* Corresponding author; email: jchandra{at}mdanderson.org.
The bcr/abl kinase has been targeted for the treatment of chronic myelogenous leukemia (CML) by imatinib mesylate. While imatinib has been extremely effective for chronic phase CML, blast crisis CML and Ph+ ALL are often resistant. In particular, mutation of the T315 residue in the bcr/abl activation loop renders cells highly resistant to imatinib and to second-generation kinase inhibitors such as BMS354825 or AMN107. Adaphostin is a tyrphostin that was originally intended to inhibit the bcr/abl kinase by competing with its peptide substrates. Recent findings have, in addition, implicated the capacity to generate reactive oxygen species (ROS) in the cytotoxic mechanism of adaphostin. In view of this unique mode of action, we examined the effects of adaphostin on numerous imatinib-resistant leukemia models, including imatinib-resistant CML and Ph+ ALL cell lines, cells harboring point mutations in bcr/abl, and specimens from imatinib-resistant CML patients, using assays for intracellular ROS, apoptosis and clonogenicity. Every cell line model of imatinib resistance examined remained fully sensitive to adaphostin-induced cell death. Collectively, these data suggest that ROS generation by adaphostin overcomes even the most potent imatinib resistance in CML and Ph+ ALL.

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