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Cancer Therapy: Preclinical |
Authors' Affiliations: 1 Section of Experimental Haematology, Division of Cancer Sciences and Molecular Pathology, University of Glasgow; 2 Academic Transfusion Medicine Unit, Scottish National Blood Transfusion Service, Glasgow, United Kingdom; and 3 Terry Fox Laboratory, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
Requests for reprints: Tessa L. Holyoake, Section of Experimental Haematology, Division of Cancer Sciences and Molecular Pathology, University of Glasgow, Level 3, Queen Elizabeth Building, Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2ER, United Kingdom. Phone: 44-141-211-1202; Fax: 44-141-211-0414; E-mail: tlh1g{at}clinmed.gla.ac.uk.
Purpose: Primitive quiescent chronic myeloid leukemia (CML) cells are biologically resistant to imatinib mesylate, an inhibitor of the p210BCR-ABL kinase. The present study was designed to investigate whether either continuous or intermittent exposure of these cells to granulocyte-colony stimulating factor (G-CSF) in vitro can overcome this limitation to the effectiveness of imatinib mesylate therapy.
Experimental Design: CD34+ leukemic cells were isolated from six newly diagnosed chronic phase CML patients and cultured for 12 days in serum-free medium with or without G-CSF and/or imatinib mesylate present either continuously or intermittently (three cycles of G-CSF for 0, 1, or 4 days ± imatinib mesylate for 0, 3, or 4 days). Every 4 days, the number of residual undivided viable cells and the total number of viable cells present were measured.
Results: Intermittent but not continuous exposure to G-CSF significantly accelerated the disappearance in vitro of initially quiescent CD34+ CML cells. This resulted in 3- and 5-fold fewer of these cells remaining after 8 and 12 days, respectively, relative to continuous imatinib mesylate alone (P < 0.04). Cultures containing imatinib mesylate and intermittently added G-CSF also showed the greatest reduction in the total number of cells present after 12 days (5-fold more than imatinib mesylate alone).
Conclusion: Intermittent exposure to G-CSF can enhance the effect of imatinib mesylate on CML cells by specifically targeting the primitive quiescent leukemic elements. A protocol for treating chronic-phase CML patients with imatinib mesylate that incorporates intermittent G-CSF exposure may offer a novel strategy for obtaining improved responses in vivo.
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