title: STAT activation status differentiates leukemogenic from non-leukemogenic stem cells in AML and is suppressed by arsenic in t(6;9)-positive AML.
abstract: Acute myeloid leukemia (AML) is characterized by an aberrant self-renewal of hematopoietic stem cells (HSC) and a block in differentiation. The major therapeutic challenge is the characterization of the leukemic stem cell as a target for the eradication of the disease. Until now the biology of AML-associated fusion proteins (AAFPs), such as the t(15;17)-PML/RARα, t(8;21)-RUNX1/RUNX1T1 and t(6;9)-DEK/NUP214, all able to induce AML in mice, was investigated in different models and genetic backgrounds, not directly comparable to each other. To avoid the bias of different techniques and models we expressed these three AML-inducing oncogenes in an identical genetic background and compared their influence on the HSC compartment in vitro and in vivo. These AAFPs exerted differential effects on HSCs and PML/RARα, similar to DEK/NUP214, induced a leukemic phenotype from a small subpopulation of HSCs with a surface marker pattern of long-term HSC and characterized by activated STAT3 and 5. In contrast the established AML occurred from mature populations in the bone marrow. The activation of STAT5 by PML/RARα and DEK/NUP214 was confirmed in t(15;17)(PML/RARα) and t(6;9)(DEK/NUP214)-positive patients as compared to normal CD34+ cells. The activation of STAT5 was reduced upon the exposure to Arsenic which was accompanied by apoptosis in both PML/RARα- and DEK/NUP214-positive leukemic cells. These findings indicate that in AML the activation of STATs plays a decisive role in the biology of the leukemic stem cell. Furthermore we establish exposure to arsenic as a novel concept for the treatment of this high risk t(6;9)-positive AML.
authors.affiliation: Department of Hematology, Goethe University, Frankfurt, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Oancea
authors.affiliation: Department of Transfusion Medicine and Immunohematology, Goethe University, Frankfurt, Germany.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Rüster
authors.affiliation: Georg-Speyer-Haus, Institute for Biomedical Research, Frankfurt am Main, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Brill
authors.affiliation: Department of Hematology, Goethe University, Frankfurt, Germany.
authors.forename: Jessica
authors.initials: J
authors.lastname: Roos
authors.affiliation: Department of Hematology, Goethe University, Frankfurt, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Heinssmann
authors.affiliation: Department of Hematology, Goethe University, Frankfurt, Germany.
authors.forename: Gesine
authors.initials: G
authors.lastname: Bug
authors.affiliation: Department of Hematology, Goethe University, Frankfurt, Germany.
authors.forename: Afsar Ali
authors.initials: AA
authors.lastname: Mian
authors.affiliation: Department of Hematology, Goethe University, Frankfurt, Germany.
authors.forename: Nathalie Andrea
authors.initials: NA
authors.lastname: Guillen
authors.affiliation: Section of Molecular Hematology and Therapy, Department of Leukemia, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kornblau
authors.affiliation: Department of Transfusion Medicine and Immunohematology, Goethe University, Frankfurt, Germany ; University Clinic Munich, Department for Transfusion Medicine, Cell Therapy and Hemostaseology, Munich, Germany.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Henschler
authors.affiliation: Department of Hematology, Goethe University, Frankfurt, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Ruthardt
keywords: STAT5; arsenic trioxide; leukemia initiating cell; t(6:9)