1. Academic Validation
  2. Self-enforcing feedback activation between BCL6 and pre-B cell receptor signaling defines a distinct subtype of acute lymphoblastic leukemia

Self-enforcing feedback activation between BCL6 and pre-B cell receptor signaling defines a distinct subtype of acute lymphoblastic leukemia

  • Cancer Cell. 2015 Mar 9;27(3):409-25. doi: 10.1016/j.ccell.2015.02.003.
Huimin Geng 1 Christian Hurtz 1 Kyle B Lenz 2 Zhengshan Chen 1 Dirk Baumjohann 3 Sarah Thompson 2 Natalya A Goloviznina 4 Wei-Yi Chen 5 Jianya Huan 4 Dorian LaTocha 6 Erica Ballabio 7 Gang Xiao 1 Jae-Woong Lee 1 Anne Deucher 1 Zhongxia Qi 1 Eugene Park 1 Chuanxin Huang 8 Rahul Nahar 1 Soo-Mi Kweon 1 Seyedmehdi Shojaee 1 Lai N Chan 1 Jingwei Yu 1 Steven M Kornblau 9 Janetta J Bijl 10 B Hilda Ye 11 K Mark Ansel 3 Elisabeth Paietta 12 Ari Melnick 8 Stephen P Hunger 13 Peter Kurre 4 Jeffrey W Tyner 14 Mignon L Loh 15 Robert G Roeder 16 Brian J Druker 17 Jan A Burger 9 Thomas A Milne 7 Bill H Chang 2 Markus Müschen 18
Affiliations

Affiliations

  • 1 Departments of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143, USA.
  • 2 Division of Pediatric Hematology and Oncology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA; Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA.
  • 3 Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA.
  • 4 Division of Pediatric Hematology and Oncology, Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA; Papé Family Pediatric Research Institute, Oregon Health & Science University, Portland, OR 97239, USA.
  • 5 Laboratory of Biochemistry and Molecular Biology, Rockefeller University, New York, NY 10065, USA; Institute of Biochemistry and Molecular Biology, National Yang-Ming University, Taipei 11221, Taiwan.
  • 6 Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA.
  • 7 MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, OX3 9DS, UK.
  • 8 Departments of Medicine and Pharmacology, Weill Cornell Medical College, New York, NY 10065, USA.
  • 9 Department of Leukemia, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
  • 10 Hôpital Maisonneuve-Rosemont, Montreal, QC H1T 2M4, Canada.
  • 11 Department of Cell Biology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
  • 12 Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
  • 13 Division of Pediatric Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • 14 Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Department of Cell & Developmental Biology, Oregon Health & Science University, Portland, OR 97239, USA.
  • 15 Pediatric Hematology-Oncology, University of California, San Francisco, San Francisco, CA 94143, USA.
  • 16 Laboratory of Biochemistry and Molecular Biology, Rockefeller University, New York, NY 10065, USA.
  • 17 Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, USA; Howard Hughes Medical Institute, Portland, OR 97239, USA.
  • 18 Departments of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143, USA. Electronic address: markus.muschen@ucsf.edu.
Abstract

Studying 830 pre-B ALL cases from four clinical trials, we found that human ALL can be divided into two fundamentally distinct subtypes based on pre-BCR function. While absent in the majority of ALL cases, tonic pre-BCR signaling was found in 112 cases (13.5%). In these cases, tonic pre-BCR signaling induced activation of BCL6, which in turn increased pre-BCR signaling output at the transcriptional level. Interestingly, inhibition of pre-BCR-related tyrosine kinases reduced constitutive BCL6 expression and selectively killed patient-derived pre-BCR(+) ALL cells. These findings identify a genetically and phenotypically distinct subset of human ALL that critically depends on tonic pre-BCR signaling. In vivo treatment studies suggested that pre-BCR tyrosine kinase inhibitors are useful for the treatment of patients with pre-BCR(+) ALL.

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