CML is treated effectively with TKI, however two key problems remain - the insensitivity of CM HSC to TKI and the emergence of TKI-resistant BCR-ABL mutations. BCR-ABL activity is associated with increased proteasome activity and PI are cytotoxic against CML cell lines. We demonstrate that bortezomib is antiproliferative and induces apoptosis in CD34+ cells taken at diagnosis from patients with CP CML cells, with an LD50 below concentrations achieved in vivo. We also demonstrate for the first time that CD34+38- CML cells, representing the TKI-insensitive primitive HSC, are similarly susceptible. Bortezomib is associated with inhibition of proteasome activity, however that of BCR-ABL appears unaffected. Significant synergy is seen when bortezomib and dasatinib are used in combination. We also demonstrate that bortezomib is effective in inhibiting proteasome activity and inducing apoptosis in cell lines expressing BCR-ABL mutations, including T315I. Therefore we believe that bortezomib offers a potential therapeutic option in CML by targeting both TKI-insensitive stem cells and TKI-resistant BCR-ABL mutations.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:513339 |
| Date | January 2009 |
| Creators | Heaney, Nicholas Benjamin |
| Publisher | University of Glasgow |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://theses.gla.ac.uk/832/ |
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