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Treatment of Philadelphia leukemia in severe combined immunodeficient mice by combination of cyclophosphamide and bcr/abl antisense oligodeoxynucleotides.

AbstractBACKGROUND:
Philadelphia cells are human chronic myelogenous leukemia (CML) cells that contain the BCR/ABL oncogene (a fusion of the BCR and ABL genes). Selective eradication of these cells in vitro can be achieved by combined treatment with antisense phosphorothioate oligodeoxynucleotides ([S]ODNs) specifically targeted to this oncogene (bcr/abl [S]ODNs) and a suboptimal (for use as a single agent) dose of mafosfamide (the in vitro active form of cyclophosphamide).
PURPOSE:
We evaluated the ability of bcr/abl antisense [S]ODNs, alone or subsequent to treatment with a single injection of cyclophosphamide, to suppress the leukemic process induced in severe combined immunodeficient (SCID) mice by Philadelphia cells (i.e., primary CML-blast crisis [CML-BC] cells). In addition, we studied potential mechanisms that might explain the efficacy of the bcr/abl antisense [S]ODN-mafosfamide combination against Philadelphia cells in vitro.
METHODS:
The effects of treating leukemic mice with cyclophosphamide (25 mg/kg body weight; 25% of the dose required to eradicate evidence of leukemia in SCID mice) and/or bcr/abl antisense [S]ODNs were assessed by analysis of survival, by examination of bone marrow for the presence of leukemia cells (using a colony formation assay or using coupled reverse transcription and the polymerase chain reaction to screen for bcr/abl messenger RNA), and by examination of a variety of tissues for the presence of infiltrating leukemia cells. The induction of apoptosis (a cell death program) in vitro in primary CML-BC cells following treatment with bcr/abl antisense [S]ODNs plus or minus prior treatment with mafosfamide was monitored by use of a commercial assay. Relative cellular uptake of [S]ODNs by CML-BC cells treated in vitro with or without prior treatment with mafosfamide was determined by use of confocal microscopy and flow cytometry (for fluorescent [S]ODNs) or by use of blotting techniques that employed radioactively labeled probes (for extracted, unlabeled [S]ODNs). Levels of specific proteins in treated and untreated cells were determined by use of western blotting methods. Reported P values are two-sided.
RESULTS:
The disease process in leukemic mice was retarded substantially by combination treatment with cyclophosphamide and specific bcr/abl antisense [S]ODNs (P < .001, relative to treatment with specific antisense [S]ODNs alone, cyclophosphamide alone, or cyclophosphamide plus nonspecific [i.e., control] antisense [S]ODNs); 50% of the mice treated with cyclophosphamide and specific antisense [S]ODNs appeared to be cured of leukemia. The combination treatment was associated with increased induction of apoptosis. In addition, cellular uptake of bcr/abl antisense [S]ODNs appeared to be increased twofold to sixfold by prior treatment with mafosfamide. This increased uptake of [S]ODNs was associated with enhanced suppression of p210bcr/abl protein levels.
CONCLUSIONS AND IMPLICATIONS:
Combination therapy with antisense [S]ODNs targeted to specific oncogenes and less toxic doses of anticancer drugs may represent a rational strategy to purpose for the treatment of human leukemias.
AuthorsT Skorski, M Nieborowska-Skorska, P Wlodarski, D Perrotti, G Hoser, J Kawiak, M Majewski, L Christensen, R V Iozzo, B Calabretta
JournalJournal of the National Cancer Institute (J Natl Cancer Inst) Vol. 89 Issue 2 Pg. 124-33 (Jan 15 1997) ISSN: 0027-8874 [Print] United States
PMID8998181 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Antineoplastic Agents
  • DNA Probes
  • Oligonucleotides, Antisense
  • Thionucleotides
  • mafosfamide
  • Cyclophosphamide
  • Fusion Proteins, bcr-abl
Topics
  • Animals
  • Antineoplastic Agents (therapeutic use)
  • Apoptosis (drug effects)
  • Blotting, Western
  • Bone Marrow (drug effects)
  • Bone Marrow Cells
  • Cyclophosphamide (analogs & derivatives, therapeutic use)
  • DNA Probes
  • Flow Cytometry
  • Fusion Proteins, bcr-abl (biosynthesis, drug effects, genetics)
  • Gene Expression Regulation, Neoplastic (drug effects)
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive (drug therapy, metabolism)
  • Mice
  • Mice, SCID
  • Oligonucleotides, Antisense (therapeutic use)
  • Philadelphia Chromosome
  • Polymerase Chain Reaction
  • Survival Analysis
  • Thionucleotides (therapeutic use)
  • Treatment Outcome
  • Tumor Cells, Cultured

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