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Blood, 1 March 2001, Vol. 97, No. 5, pp. 1427-1434
NEOPLASIA
Vascular endothelial cell growth factor is an autocrine promoter
of abnormal localized immature myeloid precursors and leukemia
progenitor formation in myelodysplastic syndromes
William T. Bellamy,
Lynne Richter,
Davuud Sirjani,
Concepcion Roxas,
Betty Glinsmann-Gibson,
Yvette Frutiger,
Thomas M. Grogan, and
Alan F. List
From the Department of Pathology, the Department of
Hematology/Oncology, and the Bone Marrow Transplant Program, The
Arizona Cancer Center, University of Arizona, Tucson, AZ.
Vascular endothelial growth factor (VEGF) is a potent angiogenic
peptide with biologic effects that include regulation of hematopoietic
stem cell development, extracellular matrix remodeling, and
inflammatory cytokine generation. To delineate the potential role of
VEGF in patients with myelodysplastic syndrome (MDS), VEGF protein and
receptor expression and its functional significance in MDS bone marrow
(BM) were evaluated. In BM clot sections from normal donors,
low-intensity cytoplasmic VEGF expression was detected infrequently in
isolated myeloid elements. However, monocytoid precursors in chronic
myelomonocytic leukemia (CMML) expressed VEGF in an intense
cytoplasmic pattern with membranous co-expression of the Flt-1 or KDR
receptors, or both. In situ hybridization confirmed the presence of
VEGF mRNA in the neoplastic monocytes. In acute myelogenous leukemia
(AML) and other MDS subtypes, intense co-expression of VEGF and one or
both receptors was detected in myeloblasts and immature myeloid
elements, whereas erythroid precursors and lymphoid cells lacked VEGF
and receptor expression. Foci of abnormal localized immature myeloid
precursors (ALIP) co-expressed VEGF and Flt-1 receptor, suggesting
autocrine cytokine interaction. Antibody neutralization of VEGF
inhibited colony-forming unit (CFU)-leukemia formation in 9 of 15 CMML
and RAEB-t patient specimens, whereas VEGF stimulated leukemia colony
formation in 12 patients. Neutralization of VEGF activity suppressed
the generation of tumor necrosis factor- and interleukin-1 from
MDS BM-mononuclear cells and BM-stroma and promoted the formation of
CFU-GEMM and burst-forming unit-erythroid in methylcellulose cultures.
These findings indicate that autocrine production of VEGF may
contribute to leukemia progenitor self-renewal and inflammatory
cytokine elaboration in CMML and MDS and thus provide a biologic
rationale for ALIP and its adverse prognostic relevance in high-risk MDS.

CiteULike Connotea Del.icio.us Digg Reddit Technorati What's this?
Related Letter in Blood Online:
-
Misleading information about ALIP and VEGF in myelodysplasia
- Manzoor H. Mangi, William T. Bellamy, Thomas M. Grogan, and Alan F. List
Blood 2001 98: 1272-1273.
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