Tamai M, Furuichi Y, Kasai S, Ando N, Harama D, Goi K, Inukai T, Kagami K, Abe M, Ichikawa H, Sugita K
Department of Pediatrics, Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan.
Division of Genetics, National Cancer Center Research Institute, Tokyo, Japan.
Leuk Res. 2017 Oct;61:68-76. doi: 10.1016/j.leukres.2017.08.013. Epub 2017 Sep 14.
Fms-like tyrosine kinase 3 (FLT3) is highly expressed in mixed-lineage leukemia (MLL) gene-rearranged acute lymphoblastic leukemia (MLL+ALL) with a dismal prognosis. We previously reported that FLT3 ligand (FL) stimulation induced cell cycle arrest in MLL+ALL cells leading to resistance against anti-leukemic agents. Given that FL stimulation enhanced transforming growth factor (TGF)β1 mRNA levels in MLL+ALL cells, we extensively examined the effect of TGFβ1 on the cell cycle progression and chemosensitivity in MLL+ALL cells, and found that TGFβ1 stimulation induced MLL+ALL cells into cell cycle arrest resistant to arabinosyl cytosine; its effect was markedly enhanced in synergy with FL. Thus, it is likely that TGFβ1 and FL, both abundantly produced by bone marrow stromal cells, function in a coordinated manner to render MLL+ALL cells chemoresistant, which should lead to the development of minimal residual disease (MRD) resulting in relapse. The use of inhibitors against FLT3 and TGFβ1 may become a useful strategy for eradicating MRD in MLL+ALL.
Fms样酪氨酸激酶3(FLT3)在混合谱系白血病(MLL)基因重排的急性淋巴细胞白血病(MLL + ALL)中高表达,预后不良。我们之前报道过,FLT3配体(FL)刺激会导致MLL + ALL细胞发生细胞周期阻滞,从而产生对抗白血病药物的耐药性。鉴于FL刺激会提高MLL + ALL细胞中转化生长因子(TGF)β1的mRNA水平,我们广泛研究了TGFβ1对MLL + ALL细胞周期进程和化疗敏感性的影响,发现TGFβ1刺激会使MLL + ALL细胞进入对阿糖胞苷耐药的细胞周期阻滞状态;其作用在与FL协同作用时会显著增强。因此,骨髓基质细胞大量产生的TGFβ1和FL可能以协同方式发挥作用,使MLL + ALL细胞产生化疗耐药性,这可能导致微小残留病(MRD)的出现并引发复发。使用针对FLT3和TGFβ1的抑制剂可能成为消除MLL + ALL中MRD的有效策略。
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