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Blood, 1 January 2002, Vol. 99, No. 1, pp. 319-325

NEOPLASIA

Primitive, quiescent, Philadelphia-positive stem cells from patients with chronic myeloid leukemia are insensitive to STI571 in vitro

Susan M. Graham, Heather G. Jørgensen, Elaine Allan, Charlie Pearson, Michael J. Alcorn, Linda Richmond, and Tessa L. Holyoake

From the Departments of Medicine and Haematology, Royal Infirmary, Glasgow, Scotland.

In clinical trials, the tyrosine kinase inhibitor STI571 has proven highly effective in reducing leukemic cell burden in chronic myeloid leukemia (CML). The overall sensitivity of CML CD34+ progenitor cells to STI571 and the degree to which cell death was dependent on cell cycle status were determined. Stem cells (Lin-CD34+) from the peripheral blood of patients with CML in chronic phase and from granulocyte-colony-stimulating factor-mobilized healthy donors were labeled with carboxy-fluorescein diacetate succinimidyl diester dye to enable high-resolution tracking of cell division. Then they were cultured for 3 days with and without growth factors ± STI571. After culture, the cells were separated by fluorescence-activated cell sorting into populations of viable quiescent versus cycling cells for genotyping. For healthy controls, in the presence of growth factors, STI571 affected neither cell cycle kinetics nor recovery of viable cells. In the absence of growth factors, normal cells were unable to divide. For CML samples, in the presence or absence of growth factors, the response to STI571 was variable. In the most sensitive cases, STI571 killed almost all dividing cells; however, a significant population of viable CD34+ cells was recovered in the undivided peak and confirmed to be part of the leukemic clone. STI571 also appeared to exhibit antiproliferative activity on the quiescent population. These studies confirm that CML stem cells remain viable in a quiescent state even in the presence of growth factors and STI571. Despite dramatic short-term responses in vivo, such in vitro insensitivity to STI571, in combination with its demonstrated antiproliferative activity, could translate into disease relapse after prolonged therapy.

© 2002 by The American Society of Hematology.
 

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PNAS, December 14, 2004; 101(50): 17456 - 17461.
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NEJMHome page
C. H.M. Jamieson, L. E. Ailles, S. J. Dylla, M. Muijtjens, C. Jones, J. L. Zehnder, J. Gotlib, K. Li, M. G. Manz, A. Keating, et al.
Granulocyte-Macrophage Progenitors as Candidate Leukemic Stem Cells in Blast-Crisis CML
N. Engl. J. Med., August 12, 2004; 351(7): 657 - 667.
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X. Jiang, Y. Zhao, W.-Y. Chan, S. Vercauteren, E. Pang, S. Kennedy, F. Nicolini, A. Eaves, and C. Eaves
Deregulated expression in Ph+ human leukemias of AHI-1, a gene activated by insertional mutagenesis in mouse models of leukemia
Blood, May 15, 2004; 103(10): 3897 - 3904.
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JNCI J Natl Cancer InstHome page
R. J. Jones, W. H. Matsui, and B. D. Smith
Cancer Stem Cells: Are We Missing the Target?
J Natl Cancer Inst, April 21, 2004; 96(8): 583 - 585.
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S. Chu, M. Holtz, M. Gupta, and R. Bhatia
BCR/ABL kinase inhibition by imatinib mesylate enhances MAP kinase activity in chronic myelogenous leukemia CD34+ cells
Blood, April 15, 2004; 103(8): 3167 - 3174.
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K. Bartolovic, S. Balabanov, U. Hartmann, M. Komor, A. M. Boehmler, H.-J. Buhring, R. Mohle, D. Hoelzer, L. Kanz, W.-K. Hofmann, et al.
Inhibitory effect of imatinib on normal progenitor cells in vitro
Blood, January 15, 2004; 103(2): 523 - 529.
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S. Appel, A. M. Boehmler, F. Grunebach, M. R. Muller, A. Rupf, M. M. Weck, U. Hartmann, V. L. Reichardt, L. Kanz, T. H. Brummendorf, et al.
Imatinib mesylate affects the development and function of dendritic cells generated from CD34+ peripheral blood progenitor cells
Blood, January 15, 2004; 103(2): 538 - 544.
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D. G. Gilliland, C. T. Jordan, and C. A. Felix
The Molecular Basis of Leukemia
Hematology, January 1, 2004; 2004(1): 80 - 97.
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P. La Rosee, K. Johnson, A. S. Corbin, E. P. Stoffregen, E. M. Moseson, S. Willis, M. M. Mauro, J. V. Melo, M. W. Deininger, and B. J. Druker
In vitro efficacy of combined treatment depends on the underlying mechanism of resistance in imatinib-resistant Bcr-Abl-positive cell lines
Blood, January 1, 2004; 103(1): 208 - 215.
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M. Gardembas, P. Rousselot, M. Tulliez, M. Vigier, A. Buzyn, F. Rigal-Huguet, L. Legros, M. Michallet, C. Berthou, N. Cheron, et al.
Results of a prospective phase 2 study combining imatinib mesylate and cytarabine for the treatment of Philadelphia-positive patients with chronic myelogenous leukemia in chronic phase
Blood, December 15, 2003; 102(13): 4298 - 4305.
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Mol Cancer ResHome page
K. M. Kirschner and K. Baltensperger
Erythropoietin Promotes Resistance Against the Abl Tyrosine Kinase Inhibitor Imatinib (STI571) in K562 Human Leukemia Cells
Mol. Cancer Res., November 1, 2003; 1(13): 970 - 980.
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NEJMHome page
J. M. Goldman and J. V. Melo
Chronic Myeloid Leukemia -- Advances in Biology and New Approaches to Treatment
N. Engl. J. Med., October 9, 2003; 349(15): 1451 - 1464.
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Pharmacol. Rev.Home page
M. W. N. Deininger and B. J. Druker
Specific Targeted Therapy of Chronic Myelogenous Leukemia with Imatinib
Pharmacol. Rev., September 1, 2003; 55(3): 401 - 423.
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C. Gambacorti-Passerini, R. Piazza, M. D'Incalci, A. Corbin, P. La Rosee, E. Stoffregen, B. Druker, and M. Deininger
Bcr-Abl mutations, resistance to imatinib, and imatinib plasma levels
Blood, September 1, 2003; 102(5): 1933 - 1935.
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J. H. Antin
A 41-Year-Old Woman With Chronic Myelogenous Leukemia
JAMA, August 27, 2003; 290(8): 1083 - 1090.
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R. Bhatia, M. Holtz, N. Niu, R. Gray, D. S. Snyder, C. L. Sawyers, D. A. Arber, M. L. Slovak, and S. J. Forman
Persistence of malignant hematopoietic progenitors in chronic myelogenous leukemia patients in complete cytogenetic remission following imatinib mesylate treatment
Blood, June 15, 2003; 101(12): 4701 - 4707.
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F.-X. Mahon, F. Belloc, V. Lagarde, C. Chollet, F. Moreau-Gaudry, J. Reiffers, J. M. Goldman, and J. V. Melo
MDR1 gene overexpression confers resistance to imatinib mesylate in leukemia cell line models
Blood, March 15, 2003; 101(6): 2368 - 2373.
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B. J. Druker
Overcoming Resistance to Imatinib by Combining Targeted Agents
Mol. Cancer Ther., March 1, 2003; 2(3): 225 - 226.
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C. Gambacorti-Passerini, M. Zucchetti, D. Russo, R. Frapolli, M. Verga, S. Bungaro, L. Tornaghi, F. Rossi, P. Pioltelli, E. Pogliani, et al.
{alpha}1 Acid Glycoprotein Binds to Imatinib (STI571) and Substantially Alters Its Pharmacokinetics in Chronic Myeloid Leukemia Patients
Clin. Cancer Res., February 1, 2003; 9(2): 625 - 632.
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A. Burchert, S. Wolfl, M. Schmidt, C. Brendel, B. Denecke, D. Cai, L. Odyvanova, T. Lahaye, M. C. Muller, T. Berg, et al.
Interferon-alpha , but not the ABL-kinase inhibitor imatinib (STI571), induces expression of myeloblastin and a specific T-cell response in chronic myeloid leukemia
Blood, January 1, 2003; 101(1): 259 - 264.
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B. J. Druker, S. G. O'Brien, J. Cortes, and J. Radich
Chronic Myelogenous Leukemia
Hematology, January 1, 2002; 2002(1): 111 - 135.
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