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

FC Guibal, M Alberich-Jorda, H Hirai… - Blood, The Journal …, 2009 - ashpublications.org
FC Guibal, M Alberich-Jorda, H Hirai, A Ebralidze, E Levantini, A Di Ruscio, P Zhang…
Blood, The Journal of the American Society of Hematology, 2009ashpublications.org
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 α. Treatment with retinoic acid leads to degradation of promyelocytic-
retinoic acid receptor α protein and disappearance of leukemic cells; however, 30% of APL
patients relapse after treatment. One potential mechanism for relapse is the persistence of …
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 α. Treatment with retinoic acid leads to degradation of promyelocytic-retinoic acid receptor α 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+, FcγRIII/II+, Gr1int) 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 α (C/EBPα) possibly through a methylation-dependent mechanism, indicating that C/EBPα 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.
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