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Blood, 15 July 2001, Vol. 98, No. 2, pp. 495-497
BRIEF REPORT
Expression of p15ink4b gene during
megakaryocytic differentiation of normal and myelodysplastic
hematopoietic progenitors
Luciana Teofili,
Maurizio Martini,
Antonella Di Mario,
Sergio Rutella,
Raffaella Urbano,
Myriam Luongo,
Giuseppe Leone, and
Luigi Maria Larocca
From the Institutes of Hematology and Pathology,
Università Cattolica del Sacro Cuore, Rome, Italy.
In myelodysplastic syndrome (MDS), the expression of the
cyclin-dependent kinase inhibitor p15ink4B (p15) is
frequently decreased because of the aberrant methylation of the gene
promoter; p15 is normally up-regulated during megakaryocytic differentiation. It was hypothesized that p15 methylation and deregulation of gene expression contribute to defective
megakaryocytopoiesis in patients with MDS. Here it is shown that the
increasing autocrine production of TGF- 1 stimulates
megakaryocytic differentiation in normal CD34+ cells and
that p15 mediates, at least in part, this effect. This TGF- 1-dependent pathway is altered in MDS CD34+
progenitors because of p15 methylation. The demethylating agent 2-deoxyAZAcytidin can restore the normal demethylated state of the
p15 gene and increase its expression. Nevertheless, MDS
CD34+ cells only poorly differentiate to the megakaryocytic
lineage. These findings suggest that p15 methylation occurs in a
neoplastic clone with a profound defect of cell proliferation,
survival, and differentiation that cannot be overcome by using a
demethylating drug.

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