Specific, targetable interactions with the microenvironment influence imatinib-resistant chronic myeloid leukemia
LEUKEMIA
Authors: Kumar, Rahul; Pereira, Raquel S.; Zanetti, Costanza; Minciacchi, Valentina R.; Merten, Maximilian; Meister, Melanie; Niemann, Julian; Dietz, Marina S.; Ruessel, Nina; Schnuetgen, Frank; Tamai, Minori; Akahane, Koshi; Inukai, Takeshi; Oellerich, Thomas; Kvasnicka, Hans Michael; Pfeifer, Heike; Nicolini, Franck E.; Heilemann, Mike; Van Etten, Richard A.; Krause, Daniela S.
Abstract
Therapy resistance in leukemia may be due to cancer cell-intrinsic and/or -extrinsic mechanisms. Mutations within BCR-ABL1, the oncogene giving rise to chronic myeloid leukemia (CML), lead to resistance to tyrosine kinase inhibitors (TKI), and some are associated with clinically more aggressive disease and worse outcome. Using the retroviral transduction/transplantation model of CML and human cell lines we faithfully recapitulate accelerated disease course in TKI resistance. We show in various models, that murine and human imatinib-resistant leukemia cells positive for the oncogene BCR-ABL1(T315I) differ from BCR-ABL1 native (BCR-ABL1) cells with regards to niche location and specific niche interactions. We implicate a pathway via integrin beta 3, integrin-linked kinase (ILK) and its role in deposition of the extracellular matrix (ECM) protein fibronectin as causative of these differences. We demonstrate a trend towards a reduced BCR-ABL1(T315I+) tumor burden and significantly prolonged survival of mice with BCR-ABL1(T315I+) CML treated with fibronectin or an ILK inhibitor in xenogeneic and syngeneic murine transplantation models, respectively. These data suggest that interactions with ECM proteins via the integrin beta 3/ILK-mediated signaling pathway in BCR-ABL1(T315I+) cells differentially and specifically influence leukemia progression. Niche targeting via modulation of the ECM may be a feasible therapeutic approach to consider in this setting.
The incidence, genetic characteristics, and prognosis of leukemia with concurrent pathogenic fusion genes: a series of 25 cases from a large cohort of leukemia patients
CANCER GENE THERAPY
Authors: Chen, Xue; Wang, Fang; Wang, Tong; Zhang, Yang; Ma, Xiaoli; Yuan, Lili; Teng, Wen; Guo, Lei; Liu, Mingyue; Liu, Ming; Chen, Jiaqi; Nie, Daijing; Zhang, Yu; Zhou, Xiaosu; Wang, Mangju; Chen, Kylan N.; Zhu, Ping; Liu, Hongxing
Abstract
Recurrent fusion genes (FGs) with clinical significances in leukemias are mainly mutually exclusive, and the coexistence of different FGs has been rarely reported. In this study, we retrospectively analyzed the incidence, genetic characteristics, and prognosis of leukemias with concurrent pathogenic FGs, which commonly reported in hematological malignancies in 8226 leukemia patients. A total of 25 patients with coexistence of double FGs were identified, accounting for 0.30% of all cases enrolled. More than half of the cases (14/25, 56%) were diagnosed as chronic myeloid leukemia in accelerated or blast phase, another six and five cases were acute myeloid leukemia and acute lymphocytic leukemia, respectively. Most cases (20/25, 80%) carried constitutively activated tyrosine kinases FGs (BCR-ABL1 or ETV6-PDGFRB) and transcription factors associated FGs simultaneously. Of the 11 patients with contemporaneous karyotype, 5 (45%) showed visible chromosomal abnormalities corresponding to both FGs. The concurrency of FGs was often associated with disease progressions. The prognosis was pessimistic for patients with concurrent FGs, even with the combination of targeted therapy and chemotherapy. Performing allogeneic hematopoietic stem cell transplantation as soon as possible after complete remission can ameliorate the dismal prognosis.