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Cited by 221

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PP2A-activating drugs selectively eradicate TKI-resistant chronic myeloid leukemic stem cells

Open access
Neviani, Paolo, Harb, Jason G., Oaks, Joshua J., Santhanam, Ramasamy, Walker, Christopher J., Ellis, Justin J., Ferenchak, Gregory, Dorrance, Adrienne M., Paisie, Carolyn A., Eiring, Anna M., Ma, Yihui, Mao, Hsiaoyin C., Zhang, Bin, Wunderlich, Mark, May, Philippa C., Sun, Chaode, Saddoughi, Sahar A., Bielawski, Jacek, Blum, William, Klisovic, Rebecca B., Solt, Janelle A., Byrd, John C., Volinia, Stefano, Cortes, Jorge, Huettner, Claudia S., Koschmieder, Steffen, Holyoake, Tessa L., Devine, Steven, Caligiuri, Michael A., Croce, Carlo M., Garzon, Ramiro, Ogretmen, Besim, Arlinghaus, Ralph B., Chen, Ching-Shih, Bittman, Robert, Hokland, Peter, Roy, Denis-Claude, Milojkovic, Dragana, Apperley, Jane, Goldman, John M., Reid, Alistair, Mulloy, James C., Bhatia, Ravi, Marcucci, Guido, Perrotti, Danilo·2013·Journal of Clinical Investigation

Abstract

The success of tyrosine kinase inhibitors (TKIs) in treating chronic myeloid leukemia (CML) depends on the requirement for BCR-ABL1 kinase activity in CML progenitors. However, CML quiescent HSCs are TKI resistant and represent a BCR-ABL1 kinase-independent disease reservoir. Here we have shown that persistence of leukemic HSCs in BM requires inhibition of the tumor suppressor protein phosphatase 2A (PP2A) and expression--but not activity--of the BCR-ABL1 oncogene. Examination of HSCs from CML patients and healthy individuals revealed that PP2A activity was suppressed in CML compared with normal HSCs. TKI-resistant CML quiescent HSCs showed increased levels of BCR-ABL1, but very low kinase activity. BCR-ABL1 expression, but not kinase function, was required for recruitment of JAK2, activation of a JAK2/β-catenin survival/self-renewal pathway, and inhibition of PP2A. PP2A-activating drugs (PADs) markedly reduced survival and self-renewal of CML quiescent HSCs, but not normal quiescent HSCs, through BCR-ABL1 kinase-independent and PP2A-mediated inhibition of JAK2 and β-catenin. This led to suppression of human leukemic, but not normal, HSC/progenitor survival in BM xenografts and interference with long-term maintenance of BCR-ABL1-positive HSCs in serial transplantation assays. Targeting the JAK2/PP2A/β-catenin network in quiescent HSCs with PADs (e.g., FTY720) has the potential to treat TKI-refractory CML and relieve lifelong patient dependence on TKIs.

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Authors
Neviani, P., Harb, J. G., Oaks, J. J., Santhanam, R., Walker, C. J., Ellis, J. J., Ferenchak, G., Dorrance, A. M., Paisie, C. A., Eiring, A. M., Ma, Y., Mao, H. C., Zhang, B., Wunderlich, M., May, P. C., Sun, C., Saddoughi, S. A., Bielawski, J., Blum, W., Klisovic, R. B., Solt, J. A., Byrd, J. C., Volinia, S., Cortes, J., Huettner, C. S., Koschmieder, S., Holyoake, T. L., Devine, S., Caligiuri, M. A., Croce, C. M., Garzon, R., Ogretmen, B., Arlinghaus, R. B., Chen, C.-S., Bittman, R., Hokland, P., Roy, D.-C., Milojkovic, D., Apperley, J., Goldman, J. M., Reid, A., Mulloy, J. C., Bhatia, R., Marcucci, G., & Perrotti, D.
Venue
Journal of Clinical Investigation
Published
2013-09-03
Volume
123
Issue
10
Pages
4144-4157
ISSN
0021-9738 (ISSN-L)
OpenAlex
W2021635600
Cited by
221
References
8
FWCI
17.06
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: PP2A-activating drugs selectively eradicate TKI-resistant chronic myeloid leukemic stem cells. https://app.cochat.ai/papers/10.1172/jci68951
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Neviani, P., Harb, J. G., Oaks, J. J., Santhanam, R., Walker, C. J., Ellis, J. J., Ferenchak, G., Dorrance, A. M., Paisie, C. A., Eiring, A. M., Ma, Y., Mao, H. C., Zhang, B., Wunderlich, M., May, P. C., Sun, C., Saddoughi, S. A., Bielawski, J., Blum, W., . . . Perrotti, D. (2013). PP2A-activating drugs selectively eradicate TKI-resistant chronic myeloid leukemic stem cells. Journal of Clinical Investigation. https://doi.org/10.1172/jci68951

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.