Identification of a myeloid committed progenitor as the cancer-initiating cell in acute promyelocytic leukemia

Author(s):Show less -

Guibal, Florence C. ^{[1, 2]} ; Alberich-Jorda, Meritxell ^{[1, 2]} ; Hirai, Hideyo ^{[1, 2]} ; Ebralidze, Alexander ^{[1, 2]} ; Levantini, Elena ^{[1, 2]} ; Di Ruscio, Annalisa ^{[1, 2]} ; Zhang, Pu ^{[1, 2]} ; Santana-Lemos, Barbara A. ^[3] ; Neuberg, Donna ^[4] ; Wagers, Amy J. ^{[1, 5]} ; Rego, Eduardo M. ^[3] ; Tenen, Daniel G. ^{[1, 2, 6]}

Affiliation

^[1] Harvard Stem Cell Inst, Boston, MA - USA

^[2] Harvard Univ, Ctr Life Sci, Sch Med, Boston, MA 02115 - USA

^[3] Univ Sao Paulo, Div Hematol, Dept Internal Med, Med Sch Ribeirao Preto, Ctr Cell Based Therapy, Sao Paulo - Brazil

^[4] Dana Farber Canc Inst, Boston, MA 02115 - USA

^[5] Harvard Univ, Sect Dev & Stem Cell Biol, Joslin Diabet Ctr, Dept Stem Cell & Regenerat Biol, Boston, MA 02115 - USA

^[6] Natl Univ Singapore, Canc Sci Inst, Singapore 117548 - Singapore

• Document type: Journal article
• Source: Blood; v. 114, n. 27, p. 5415-5425, 2009.
• Web of Science Citations: 94

Abstract

Acute promyelocytic leukemia (APL) is characterized by a block in differentiation and accumulation of promyelocytes in the bone marrow and blood. The majority of APL patients harbor the t(15: 17) translocation leading to expression of the fusion protein promyelocytic-retinoic acid receptor alpha. Treatment with retinoic acid leads to degradation of promyelocytic-retinoic acid receptor alpha protein and disappearance of leukemic cells; however, 30% of APL patients relapse after treatment. One potential mechanism for relapse is the persistence of cancer "stem" cells in hematopoietic organs after treatment. Using a novel sorting strategy we developed to isolate murine myeloid cells at distinct stages of differentiation, we identified a population of committed myeloid cells (CD34(+), c-kit(+), Fc gamma RIII/II+, Gr1(int)) that accumulates in the spleen and bone marrow in a murine model of APL. We observed that these cells are capable of efficiently generating leukemia in recipient mice, demonstrating that this population represents the APL cancer-initiating cell. These cells down-regulate the transcription factor CCAAT/enhancer binding protein alpha (C/EBP alpha) possibly through a methylation-dependent mechanism, indicating that C/EBP alpha deregulation contributes to transformation of APL cancer-initiating cells. Our findings provide further understanding of the biology of APL by demonstrating that a committed transformed progenitor can initiate and propagate the disease. (Blood. 2009; 114: 5415-5425) (AU)