Chronic myeloid leukemia stem cells are not dependent on Bcr-Abl kinase activity for their survival

Blood. 2012 Feb 9;119(6):1501-10. doi: 10.1182/blood-2010-12-326843. Epub 2011 Dec 19.

Abstract

Recent evidence suggests chronic myeloid leukemia (CML) stem cells are insensitive to kinase inhibitors and responsible for minimal residual disease in treated patients. We investigated whether CML stem cells, in a transgenic mouse model of CML-like disease or derived from patients, are dependent on Bcr-Abl. In the transgenic model, after retransplantation, donor-derived CML stem cells in which Bcr-Abl expression had been induced and subsequently shut off were able to persist in vivo and reinitiate leukemia in secondary recipients on Bcr-Abl reexpression. Bcr-Abl knockdown in human CD34(+) CML cells cultured for 12 days in physiologic growth factors achieved partial inhibition of Bcr-Abl and downstream targets p-CrkL and p-STAT5, inhibition of proliferation and colony forming cells, but no reduction of input cells. The addition of dasatinib further inhibited p-CrkL and p-STAT5, yet only reduced input cells by 50%. Complete growth factor withdrawal plus dasatinib further reduced input cells to 10%; however, the surviving fraction was enriched for primitive leukemic cells capable of growth in a long-term culture-initiating cell assay and expansion on removal of dasatinib and addition of growth factors. Together, these data suggest that CML stem cell survival is Bcr-Abl kinase independent and suggest curative approaches in CML must focus on kinase-independent mechanisms of resistance.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptor Proteins, Signal Transducing / metabolism
  • Animals
  • Antigens, CD34 / metabolism
  • Apoptosis / drug effects
  • Blotting, Western
  • Cell Line, Tumor
  • Cell Proliferation / drug effects
  • Cell Survival / drug effects
  • Dasatinib
  • Dose-Response Relationship, Drug
  • Flow Cytometry
  • Fusion Proteins, bcr-abl / antagonists & inhibitors
  • Fusion Proteins, bcr-abl / genetics
  • Fusion Proteins, bcr-abl / metabolism*
  • Gene Expression Regulation, Leukemic
  • Gene Knockout Techniques
  • HEK293 Cells
  • Humans
  • K562 Cells
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / genetics
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / metabolism*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology
  • Mice
  • Mice, Transgenic
  • Neoplastic Stem Cells / metabolism*
  • Neoplastic Stem Cells / pathology
  • Nuclear Proteins / metabolism
  • Protein Kinase Inhibitors / pharmacology
  • Pyrimidines / pharmacology
  • Reverse Transcriptase Polymerase Chain Reaction
  • STAT5 Transcription Factor / metabolism
  • Thiazoles / pharmacology

Substances

  • Adaptor Proteins, Signal Transducing
  • Antigens, CD34
  • CRKL protein
  • Nuclear Proteins
  • Protein Kinase Inhibitors
  • Pyrimidines
  • STAT5 Transcription Factor
  • Thiazoles
  • Fusion Proteins, bcr-abl
  • Dasatinib