title: Potentiation of antitumor effects of cyclophosphamide derivatives in B-chronic lymphocytic leukemia cells by 2-chloro-2'-deoxyadenosine.
abstract: Because 2-chloro-2'-deoxyadenosine (CdA) is active in B-chronic lymphocytic leukemia (B-CLL), and may interfere with DNA repair, we investigated the potentiating effect of CdA on the cytotoxicity induced in vitro in B-CLL lymphocytes by cyclophosphamide (CP) derivatives, which induce DNA damage by DNA cross-linking. Exposure to CdA at clinically achievable concentrations for 2 h, followed by mafosfamide (MAF) or 4-hydroxycyclophosphamide (4HC) for 22 h, resulted in synergistic cytotoxicity in the majority of B-CLL samples tested. Synergy between CdA and MAF was observed in cell samples of sensitive/untreated patients, as well as in cells of resistant/pretreated patients, particularly at the highest concentrations of MAF. In the cells treated with CdA and MAF, we observed loss in ATP and hallmarks of apoptosis, as evidenced by cellular morphology and high molecular weight DNA fragmentation. The synergy could be explained neither by an influence of MAF on the phosphorylation of CdA, nor by an increase in the incorporation of CdA into DNA in the presence of MAF. The in vitro synergy between CdA and CP derivatives provides a rationale for the use of this association in B-CLL patients.
authors.affiliation: Service d'Hématologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Van Den Neste
authors.forename: F
authors.initials: F
authors.lastname: Bontemps
authors.forename: A
authors.initials: A
authors.lastname: Delacauw
authors.forename: S
authors.initials: S
authors.lastname: Cardoen
authors.forename: I
authors.initials: I
authors.lastname: Louviaux
authors.forename: J M
authors.initials: JM
authors.lastname: Scheiff
authors.forename: E
authors.initials: E
authors.lastname: Gillis
authors.forename: P
authors.initials: P
authors.lastname: Leveugle
authors.forename: V
authors.initials: V
authors.lastname: Deneys
authors.forename: A
authors.initials: A
authors.lastname: Ferrant
authors.forename: G
authors.initials: G
authors.lastname: Van den Berghe
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000378:metabolism / Q000494:pharmacology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology* / Q000627:therapeutic use; D002470:Cell Survival / Q000187:drug effects; D017338:Cladribine / Q000494:pharmacology*; D003520:Cyclophosphamide / Q000031:analogs & derivatives / Q000378:metabolism / Q000494:pharmacology*; D004354:Drug Screening Assays, Antitumor; D004357:Drug Synergism; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors; D014316:Tritium; D014407:Tumor Cells, Cultured
chemical_list: D018906:Antineoplastic Agents, Alkylating; D014316:Tritium; C012358:4-hydroxycyclophosphamide; D017338:Cladribine; C048341:mafosfamide; D003520:Cyclophosphamide