Abstract
In acute myeloid leukemia (AML), refractory disease is a major challenge and the leukemia microenvironment may harbor refractory disease. Human AML cell lines KG-1 and HL-60 expressed receptors also found on endothelial cells (ECs) such as VEGFRs, PDGFRs, and cKit. When human AML cells were co-cultured with human umbilical vein endothelial cells (HUVECs) and primary bone marrow endothelial cell (BMECs), the AML cells were more resistant to cytarabine chemotherapy, even in transwell co-culture suggesting angiocrine regulation. Primary BMECs secreted significantly increased levels of VEGF-A and PDGF-AB after exposure to cytarabine. Pazopanib, a receptor tyrosine kinase inhibitor (RTKI) of VEGFRs, PDGFRs, and cKit, removed EC protection of AML cells and enhanced AML cell sensitivity to cytarabine. Xenograft modeling showed significant regression of AML cells and abrogation of BM hypervascularity in RTKI treated cohorts. Together, these results show direct cytotoxicity of RTKIs on AML cells and reversal of EC protection. Combining RTKIs with chemotherapy may serve as promising therapeutic strategy for patients with AML.
Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Animals
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Antimetabolites, Antineoplastic / pharmacology
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Bone Marrow Cells / cytology
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Bone Marrow Cells / drug effects
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Bone Marrow Cells / metabolism
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Cell Line, Tumor
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Cell Proliferation / drug effects
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Coculture Techniques
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Cytarabine / pharmacology
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Drug Resistance, Neoplasm / genetics*
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Endothelial Cells / cytology
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Endothelial Cells / drug effects
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Endothelial Cells / metabolism
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Gene Expression Regulation, Leukemic*
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Human Umbilical Vein Endothelial Cells / cytology
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Human Umbilical Vein Endothelial Cells / drug effects
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Human Umbilical Vein Endothelial Cells / metabolism
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Humans
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Indazoles
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Leukemia, Myeloid, Acute / drug therapy*
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Leukemia, Myeloid, Acute / genetics
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Leukemia, Myeloid, Acute / metabolism
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Leukemia, Myeloid, Acute / pathology
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Mice
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Mice, SCID
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Neoplasm Transplantation
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Neovascularization, Pathologic / genetics
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Neovascularization, Pathologic / metabolism
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Neovascularization, Pathologic / pathology
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Neovascularization, Pathologic / prevention & control*
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Platelet-Derived Growth Factor / antagonists & inhibitors
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Platelet-Derived Growth Factor / genetics
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Platelet-Derived Growth Factor / metabolism
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Protein Kinase Inhibitors / pharmacology*
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Proto-Oncogene Proteins c-kit / antagonists & inhibitors
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Proto-Oncogene Proteins c-kit / genetics
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Proto-Oncogene Proteins c-kit / metabolism
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Pyrimidines / pharmacology*
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Receptors, Platelet-Derived Growth Factor / antagonists & inhibitors
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Receptors, Platelet-Derived Growth Factor / genetics
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Receptors, Platelet-Derived Growth Factor / metabolism
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Receptors, Vascular Endothelial Growth Factor / antagonists & inhibitors
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Receptors, Vascular Endothelial Growth Factor / genetics*
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Receptors, Vascular Endothelial Growth Factor / metabolism
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Signal Transduction
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Sulfonamides / pharmacology*
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Tumor Burden / drug effects
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Vascular Endothelial Growth Factor A / antagonists & inhibitors
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Vascular Endothelial Growth Factor A / genetics
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Vascular Endothelial Growth Factor A / metabolism
Substances
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Antimetabolites, Antineoplastic
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Indazoles
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Platelet-Derived Growth Factor
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Protein Kinase Inhibitors
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Pyrimidines
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Sulfonamides
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VEGFA protein, human
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Vascular Endothelial Growth Factor A
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platelet-derived growth factor AB
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Cytarabine
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pazopanib
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Proto-Oncogene Proteins c-kit
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Receptors, Platelet-Derived Growth Factor
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Receptors, Vascular Endothelial Growth Factor