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Blood, 1 January 2008, Vol. 111, No. 1, pp. 369-375.
Prepublished online as a Blood First Edition Paper on October 4, 2007; DOI 10.1182/blood-2007-04-085480.


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Submitted April 13, 2007
Accepted September 19, 2007

Small-molecule XIAP antagonist restores caspase-9-mediated apoptosis in XIAP-positive diffuse large B-cell lymphoma cells

Saskia AGM Cillessen, John C Reed, Kate Welsh, Clemencia Pinilla, Richard Houghten, Erik Hooijberg, Jose Deurhof, Kitty CM Castricum, Pim Kortman, Corine J Hess, Gert J Ossenkoppele, Chris JLM Meijer, and Joost J Oudejans*

Department of Clinical Pathology, VU University Medical Center, Amsterdam, Netherlands
Burnham Institute for Medical Research, La Jolla, CA, United States
Torrey Pines Institute for Molecular Studies, San Diego, CA, United States
Department of Hematology, VU University Medical Center, Amsterdam, Netherlands

* Corresponding author; email: jj.oudejans{at}vumc.nl.

Clinical outcome in patients with primary nodal diffuse large B-cell lymphomas (DLBCL) is correlated with expression of inhibitors of the intrinsic apoptosis pathway, including XIAP. XIAP suppresses apoptosis through inhibiting active caspases-3, -7 and -9. In this study we investigated if the small-molecule XIAP antagonist 1396-12 induces cell death in cultured lymphoma cells of DLBCL patients. Treatment with this XIAP antagonist resulted in relief of caspase 3 inhibition and in induction of apoptosis in 16 of 20 tested DLBCL samples. Sensitivity to the XIAP antagonist was observed in both chemotherapy refractory and responsive DLBCL, but did not affect peripheral blood mononuclear cells and tonsil germinal center B-cells from healthy donors. XIAP antagonist-sensitive cases were characterized by high expression levels of XIAP, relatively low expression levels of Bcl-2, and by constitutive caspase-9 activation. These data indicate that the small-molecule XIAP antagonist can induce apoptosis in cultured DLBCL cells and therefore should be considered for possible development as a therapy for these patients. In vitro sensitivity to the XIAP antagonist can be predicted based on biological markers suggesting the possibility of pre-defining patients most likely to benefit from XIAP antagonist therapy.


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J. J. Oudejans, J. J.F. Muris, S. A.G.M. Cillessen, and C. J.L.M. Meijer
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