PP2A-activating drugs selectively eradicate tki-resistant chronic myeloid leukemic stem cells

Paolo Neviani, Jason G. Harb, Joshua J. Oaks, Ramasamy Santhanam, Christopher J. Walker, Justin J. Ellis, Gregory Ferenchak, Adrienne M. Dorrance, Carolyn A. Paisie, Anna M. Eiring, Yihui Ma, Hsiaoyin C. Mao, Bin Zhang, Mark Wunderlich, Philippa C. May, Chaode Sun, Sahar A. Saddoughi, Jacek Bielawski, William Blum, Rebecca B. KlisovicJanelle A. Solt, John C. Byrd, Stefano Volinia, Jorge Cortes, Claudia S. Huettner, Steffen Koschmieder, Tessa L. Holyoake, Steven Devine, Michael A. Caligiuri, Carlo M. Croce, Ramiro Garzon, Besim Ogretmen, Ralph B. Arlinghaus, Ching Shih Chen, Robert Bittman, Peter Hokland, Denis Claude Roy, Dragana Milojkovic, Jane Apperley, John M. Goldman, Alistair Reid, James C. Mulloy, Ravi Bhatia, Guido Marcucci, Danilo Perrotti

Research output: Contribution to journalArticle

Abstract

The success of tyrosine kinase inhibitors (TKIs) in treating chronic myeloid leukemia (CML) depends on the requirement for BCR-ABL1 kinase activity in CML progenitors. However, CML quiescent HSCs are TKI resistant and represent a BCR-ABL1 kinase-independent disease reservoir. Here we have shown that persistence of leukemic HSCs in BM requires inhibition of the tumor suppressor protein phosphatase 2A (PP2A) and expression - but not activity - of the BCR-ABL1 oncogene. Examination of HSCs from CML patients and healthy individuals revealed that PP2A activity was suppressed in CML compared with normal HSCs. TKIresistant CML quiescent HSCs showed increased levels of BCR-ABL1, but very low kinase activity. BCR-ABL1 expression, but not kinase function, was required for recruitment of JAK2, activation of a JAK2/β-catenin survival/self-renewal pathway, and inhibition of PP2A. PP2A-activating drugs (PADs) markedly reduced survival and self-renewal of CML quiescent HSCs, but not normal quiescent HSCs, through BCR-ABL1 kinase-independent and PP2A-mediated inhibition of JAK2 and β-catenin. This led to suppression of human leukemic, but not normal, HSC/progenitor survival in BM xenografts and interference with long-term maintenance of BCR-ABL1-positive HSCs in serial transplantation assays. Targeting the JAK2/PP2A/β-catenin network in quiescent HSCs with PADs (e. g., FTY720) has the potential to treat TKI-refractory CML and relieve lifelong patient dependence on TKIs.

Original languageEnglish (US)
Pages (from-to)4144-4157
Number of pages14
JournalJournal of Clinical Investigation
Volume123
Issue number10
DOIs
StatePublished - Oct 1 2013
Externally publishedYes

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Myeloid Progenitor Cells
Protein Phosphatase 2
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Phosphotransferases
Catenins
Pharmaceutical Preparations
Protein-Tyrosine Kinases
Disease Reservoirs
Tumor Suppressor Proteins
Survival
Oncogenes
Heterografts
Transplantation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Neviani, P., Harb, J. G., Oaks, J. J., Santhanam, R., Walker, C. J., Ellis, J. J., ... Perrotti, D. (2013). PP2A-activating drugs selectively eradicate tki-resistant chronic myeloid leukemic stem cells. Journal of Clinical Investigation, 123(10), 4144-4157. https://doi.org/10.1172/JCI68951

PP2A-activating drugs selectively eradicate tki-resistant chronic myeloid leukemic stem cells. / Neviani, Paolo; Harb, Jason G.; Oaks, Joshua J.; Santhanam, Ramasamy; Walker, Christopher J.; Ellis, Justin J.; Ferenchak, Gregory; Dorrance, Adrienne M.; Paisie, Carolyn A.; Eiring, Anna M.; Ma, Yihui; Mao, Hsiaoyin C.; Zhang, Bin; Wunderlich, Mark; May, Philippa C.; Sun, Chaode; Saddoughi, Sahar A.; Bielawski, Jacek; Blum, William; Klisovic, Rebecca B.; Solt, Janelle A.; Byrd, John C.; Volinia, Stefano; Cortes, Jorge; Huettner, Claudia S.; Koschmieder, Steffen; Holyoake, Tessa L.; Devine, Steven; Caligiuri, Michael A.; Croce, Carlo M.; Garzon, Ramiro; Ogretmen, Besim; Arlinghaus, Ralph B.; Chen, Ching Shih; Bittman, Robert; Hokland, Peter; Roy, Denis Claude; Milojkovic, Dragana; Apperley, Jane; Goldman, John M.; Reid, Alistair; Mulloy, James C.; Bhatia, Ravi; Marcucci, Guido; Perrotti, Danilo.

In: Journal of Clinical Investigation, Vol. 123, No. 10, 01.10.2013, p. 4144-4157.

Research output: Contribution to journalArticle

Neviani, P, Harb, JG, Oaks, JJ, Santhanam, R, Walker, CJ, Ellis, JJ, Ferenchak, G, Dorrance, AM, Paisie, CA, Eiring, AM, Ma, Y, Mao, HC, Zhang, B, Wunderlich, M, May, PC, Sun, C, Saddoughi, SA, Bielawski, J, Blum, W, Klisovic, RB, Solt, JA, Byrd, JC, Volinia, S, Cortes, J, Huettner, CS, Koschmieder, S, Holyoake, TL, Devine, S, Caligiuri, MA, Croce, CM, Garzon, R, Ogretmen, B, Arlinghaus, RB, Chen, CS, Bittman, R, Hokland, P, Roy, DC, Milojkovic, D, Apperley, J, Goldman, JM, Reid, A, Mulloy, JC, Bhatia, R, Marcucci, G & Perrotti, D 2013, 'PP2A-activating drugs selectively eradicate tki-resistant chronic myeloid leukemic stem cells', Journal of Clinical Investigation, vol. 123, no. 10, pp. 4144-4157. https://doi.org/10.1172/JCI68951
Neviani, Paolo ; Harb, Jason G. ; Oaks, Joshua J. ; Santhanam, Ramasamy ; Walker, Christopher J. ; Ellis, Justin J. ; Ferenchak, Gregory ; Dorrance, Adrienne M. ; Paisie, Carolyn A. ; Eiring, Anna M. ; Ma, Yihui ; Mao, Hsiaoyin C. ; Zhang, Bin ; Wunderlich, Mark ; May, Philippa C. ; Sun, Chaode ; Saddoughi, Sahar A. ; Bielawski, Jacek ; Blum, William ; Klisovic, Rebecca B. ; Solt, Janelle A. ; Byrd, John C. ; Volinia, Stefano ; Cortes, Jorge ; Huettner, Claudia S. ; Koschmieder, Steffen ; Holyoake, Tessa L. ; Devine, Steven ; Caligiuri, Michael A. ; Croce, Carlo M. ; Garzon, Ramiro ; Ogretmen, Besim ; Arlinghaus, Ralph B. ; Chen, Ching Shih ; Bittman, Robert ; Hokland, Peter ; Roy, Denis Claude ; Milojkovic, Dragana ; Apperley, Jane ; Goldman, John M. ; Reid, Alistair ; Mulloy, James C. ; Bhatia, Ravi ; Marcucci, Guido ; Perrotti, Danilo. / PP2A-activating drugs selectively eradicate tki-resistant chronic myeloid leukemic stem cells. In: Journal of Clinical Investigation. 2013 ; Vol. 123, No. 10. pp. 4144-4157.
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AU - Neviani, Paolo

AU - Harb, Jason G.

AU - Oaks, Joshua J.

AU - Santhanam, Ramasamy

AU - Walker, Christopher J.

AU - Ellis, Justin J.

AU - Ferenchak, Gregory

AU - Dorrance, Adrienne M.

AU - Paisie, Carolyn A.

AU - Eiring, Anna M.

AU - Ma, Yihui

AU - Mao, Hsiaoyin C.

AU - Zhang, Bin

AU - Wunderlich, Mark

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AU - Sun, Chaode

AU - Saddoughi, Sahar A.

AU - Bielawski, Jacek

AU - Blum, William

AU - Klisovic, Rebecca B.

AU - Solt, Janelle A.

AU - Byrd, John C.

AU - Volinia, Stefano

AU - Cortes, Jorge

AU - Huettner, Claudia S.

AU - Koschmieder, Steffen

AU - Holyoake, Tessa L.

AU - Devine, Steven

AU - Caligiuri, Michael A.

AU - Croce, Carlo M.

AU - Garzon, Ramiro

AU - Ogretmen, Besim

AU - Arlinghaus, Ralph B.

AU - Chen, Ching Shih

AU - Bittman, Robert

AU - Hokland, Peter

AU - Roy, Denis Claude

AU - Milojkovic, Dragana

AU - Apperley, Jane

AU - Goldman, John M.

AU - Reid, Alistair

AU - Mulloy, James C.

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AU - Marcucci, Guido

AU - Perrotti, Danilo

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