[show abstract][hide abstract] ABSTRACT: The kinetics of ribosomal RNA transcription and processing were assessed in chronic lymphocytic leukemia (CLL) lymphocytes during the initial phases of their delayed response to phytohemagglutinin. When compared to cultures of normal lymphocytes, CLL cultures developed normal augmentations in 45S rRNA precursor transcription and cleavage after a 1 hr incubation with PHA. However, failure to conserve 18S RNA subunits persisted in the CLL cultures. Subsequently the PHA-induced progressive rise in 45S RNA transcription became aborted and the over-all rate of RNA synthesis lagged far behind the levels attained by normal cultures incubated with PHA for 48 hr. CLL cultures responding to PHA in a delayed fashion exhibited efficient conservation of 18S RNA at 168 hr. In normal cultures, PHA-induced conservation of 18S RNA appeared to be independent of any effect on 45S ribosomal RNA precursor transcription. Therefore, the sluggish growth response of CLL lymphocytes was associated with a defect in one of the important mechanisms regulating assembly of new ribosomes.
Journal of Clinical Investigation 01/1972; 50(12):2485-97. · 12.81 Impact Factor
[show abstract][hide abstract] ABSTRACT: Due to its relatively slow clinical progression, B cell chronic lymphocytic leukemia (B-CLL) is classically described as a disease of accumulation rather than proliferation. However, evidence for various forms of clonal evolution suggests that B-CLL clones may be more dynamic than previously assumed. We used a nonradioactive, stable isotopic labeling method to measure B-CLL cell kinetics in vivo. Nineteen patients drank an aliquot of deuterated water (2H2O) daily for 84 days, and 2H incorporation into the deoxyribose moiety of DNA of newly divided B-CLL cells was measured by gas chromatography/mass spectrometry, during and after the labeling period. Birth rates were calculated from the kinetic profiles. Death rates were defined as the difference between calculated birth and growth rates. These analyses demonstrated that the leukemic cells of each patient had definable and often substantial birth rates, varying from 0.1% to greater than 1.0% of the entire clone per day. Those patients with birth rates greater than 0.35% per day were much more likely to exhibit active or to develop progressive disease than those with lower birth rates Thus, B-CLL is not a static disease that results simply from accumulation of long-lived lymphocytes. Rather, it is a dynamic process composed also of cells that proliferate and die, often at appreciable levels. The extent to which this turnover occurs has not been previously appreciated. A correlation between birth rates and disease activity and progression appears to exist, which may help identify patients at risk for worsening disease in advance of clinical deterioration.
Journal of Clinical Investigation 04/2005; 115(3):755-64. · 12.81 Impact Factor
[show abstract][hide abstract] ABSTRACT: Resistance to chemotherapy and drug toxicity are two major concerns of chronic lymphocytic leukaemia (B-CLL) treatment by purine nucleoside analogues (PNA, i.e. fludarabine and cladribine). We hypothesized that targeting epigenetic changes might address these issues and evaluated the effect of the histone deacetylase inhibitor valproate (VPA) at a clinically relevant concentration. VPA acted in a highly synergistic/additive manner with fludarabine and cladribine to induce apoptosis of B-CLL cells. Importantly, VPA also restored sensitivity to fludarabine in B cells from poor prognosis CLL patients who became resistant to chemotherapy. Mechanism of apoptosis induced by VPA alone or combined with fludarabine or to cladribine was caspase-dependent and involved the extrinsic pathway. VPA, but neither fludarabine nor cladribine, enhanced the production of reactive oxygen species (ROS) and inhibition of ROS with N-acetylcysteine decreases apoptosis of CLL cells. VPA stimulates hyperphosphorylation of p42/p44 ERK, cytochrome c release and overexpression of Bax and Fas. Together, our data indicate that VPA may ameliorate the outcome of PNA-based therapeutic protocols and provide a potential alternative treatment in both the relapsed and front-line resistant patients and in patients with high risk features.
British Journal of Haematology 12/2008; 144(1):41-52. · 4.94 Impact Factor
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