Abstract
Bcl-2, Bcl-xL, and Mcl-1 are three related intracellular polypeptides that have been implicated as negative regulators of apoptosis. In contrast, the partner protein Bax acts as a positive regulator of apoptosis. Based on the observation that all four of these polypeptides are expressed in a variety of acute myelogenous leukemia (AML) and acute lymphocytic leukemia (ALL) cell lines, cellular levels of these polypeptides were examined by immunoblotting in bone marrow samples harvested from 123 adult AML patients and 36 adult ALL patients before initial antileukemic therapy. Levels of Bcl-2, Mcl-1, Bcl-xL, and Bax each varied over a more than 10-fold range in different pretreatment leukemia specimens. When the 54 AML and 23 ALL samples that contained greater than 80% malignant cells were examined in greater detail, it was observed that pretreatment levels of Bcl-2 and Mcl-1 correlated with each other (R = .44,P < .001 for AML and R = .79,P < .0001 for ALL). In addition, a weak negative correlation between Bax expression and age was observed in AML samples (R = −0.35, P < .02) but not ALL samples. There was no relationship between pretreatment levels of these polypeptides and response to initial therapy. However, examination of 19 paired samples (the first harvested before chemotherapy and the second harvested 23 to 290 days later at the time of leukemic recurrence) revealed a greater than or equal to twofold increase in Mcl-1 levels in 10 of 19 pairs (7 of 15 AML and 3 of 4 ALL) at recurrence. In contrast, 2 of 19 pairs contained twofold less Mcl-1 at the time of recurrence. Approximately equal numbers of samples showed twofold increases and decreases in Bcl-2 (5 increases, 3 decreases) and Bcl-xL (1 increase, 4 decreases) at recurrence. Bax levels did not show a twofold decrease in any patient. These results, coupled with recent observations that cells overexpressing Mcl-1 are resistant to a variety of chemotherapeutic agents, raise the possibility that some chemotherapeutic regimens might select for leukemia cells with elevated levels of this particular apoptosis inhibitor.
References
74
Referenced
192
{'key': '2019101310061304700_B1', 'first-page': '417', 'article-title': 'Induction of apoptosis—New targets for cancer chemotherapy.', 'volume': '3', 'author': 'Dive', 'year': '1992', 'journal-title': 'Semin Cancer Biol'}
/ Semin Cancer Biol / Induction of apoptosis—New targets for cancer chemotherapy. by Dive (1992)10.1182/blood.V82.1.15.bloodjournal82115
/ Blood / Control of programmed cell death in normal and leukemic cells: New implications for therapy. by Sachs (1993)10.1002/1097-0142(19940415)73:8<2013::AID-CNCR2820730802>3.0.CO;2-J
/ Cancer / Apoptosis. Its significance in cancer and cancer therapy. by Kerr (1994)10.1182/blood.V89.6.1845
/ Blood / Apoptosis and the dilemma of cancer chemotherapy. by Hannun (1997)10.1016/S1054-3589(08)61069-8
/ Adv Pharmacol / Chemotherapy-induced apoptosis. by Mesner (1997)10.3109/10428199409052678
/ Leuk Lymph / Apoptotic cell death during treatment of leukemias. by Li (1994)10.1200/JCO.1997.15.1.44
/ J Clin Oncol / Phase I clinical and laboratory evaluation of topotecan and cytarabine in patients with acute leukemia. by Seiter (1997)10.1182/blood.V81.1.151.bloodjournal811151
/ Blood / Bcl-2 oncoprotein blocks chemotherapy-induced apoptosis in a human leukemia cell line. by Miyashita (1993)10.1126/science.7973635
/ Science / p53 status and the efficacy of cancer therapy in vivo. by Lowe (1994){'key': '2019101310061304700_B10'}
10.1182/blood.V86.3.1148.bloodjournal8631148
/ Blood / BCR-ABL-mediated inhibition of apoptosis with delay of G2/M transition after DNA damage: A mechanism of resistance to multiple anticancer agents. by Bedi (1995){'key': '2019101310061304700_B12'}
{'key': '2019101310061304700_B13', 'first-page': '623', 'article-title': 'Apoptotic death of tumor cells correlates with chemosensitivity, independent of p53 or Bcl-2.', 'volume': '2', 'author': 'Wu', 'year': '1996', 'journal-title': 'Clin Cancer Res'}
/ Clin Cancer Res / Apoptotic death of tumor cells correlates with chemosensitivity, independent of p53 or Bcl-2. by Wu (1996)10.1006/scbi.1995.0005
/ Semin Cancer Biol / The Bcl-2 gene family. by Craig (1995)10.1016/S0960-9822(95)00126-6
/ Curr Biol / A sticky business. by Häcker (1995)10.1182/blood.V88.2.386.bloodjournal882386
/ Blood / Molecular thanatopsis: A discourse on the Bc1-2 family and cell death. by Yang (1996){'key': '2019101310061304700_B17', 'first-page': '925', 'article-title': 'Control of apoptosis in hematopoiesis and leukemia by cytokines, tumor suppressor and oncogenes.', 'volume': '10', 'author': 'Lotem', 'year': '1996', 'journal-title': 'Leukemia'}
/ Leukemia / Control of apoptosis in hematopoiesis and leukemia by cytokines, tumor suppressor and oncogenes. by Lotem (1996)10.1038/42867
/ Nature / Double identity for proteins of the Bcl-2 family. by Reed (1997)10.1126/science.3874430
/ Science / Involvement of the bcl-2 gene in human follicular lymphoma. by Tsujimoto (1985)10.1038/348334a0
/ Nature / Bcl-2 is an inner mitochondrial membrane protein that blocks programmed cell death. by Hockenbery (1990){'key': '2019101310061304700_B21', 'first-page': '4701', 'article-title': 'Investigation of the subcellular distribution of the Bcl-2 oncoprotein: Residence in the nuclear envelope, endoplasmic reticulum, and outer mitochondrial membranes.', 'volume': '53', 'author': 'Krajewski', 'year': '1993', 'journal-title': 'Cancer Res'}
/ Cancer Res / Investigation of the subcellular distribution of the Bcl-2 oncoprotein: Residence in the nuclear envelope, endoplasmic reticulum, and outer mitochondrial membranes. by Krajewski (1993)10.1097/00001622-199511000-00012
/ Curr Opin Oncol / Regulation of apoptosis by Bcl-2 family proteins and its role in cancer and chemoresistance. by Reed (1995)10.1089/ard.1994.4.71
/ Antisense Res Dev / Reversal of chemoresistance of lymphoma cells by antisense-mediated reduction of Bcl-2 gene expression. by Kitada (1994){'key': '2019101310061304700_B24', 'first-page': '131', 'article-title': 'Inhibition of Bcl-2 with antisense oligonucleotides induces apoptosis and increases the sensitivity of AML blasts to Ara-C.', 'volume': '9', 'author': 'Keith', 'year': '1995', 'journal-title': 'Leukemia'}
/ Leukemia / Inhibition of Bcl-2 with antisense oligonucleotides induces apoptosis and increases the sensitivity of AML blasts to Ara-C. by Keith (1995){'key': '2019101310061304700_B25', 'first-page': '225', 'article-title': 'Expression of the bcl-2 oncogene protein is not specific for the 14;18 chromosomal translocation.', 'volume': '137', 'author': 'Pezzella', 'year': '1990', 'journal-title': 'Am J Pathol'}
/ Am J Pathol / Expression of the bcl-2 oncogene protein is not specific for the 14;18 chromosomal translocation. by Pezzella (1990)10.1182/blood.V78.4.1062.bloodjournal7841062
/ Blood / Immunolocalization of the Bcl-2 protein within hematopoietic neoplasms. by Zutter (1991)10.1182/blood.V82.6.1820.bloodjournal8261820
/ Blood / Bcl-2 gene hypomethylation and high-level expression in B-cell chronic lymphocytic leukemia. by Hanada (1993)10.1182/blood.V81.4.1025.bloodjournal8141025
/ Blood / Prolonged survival of B-lineage acute lymphoblastic leukemia cells is accompanied by overexpression of Bcl-2 protein. by Campana (1993)10.1007/BF01757343
/ Ann Hematol / High expression of Bcl-2 is the rule in acute lymphoblastic leukemia, except in Burkitt subtype at presentation, and is not correlated with the prognosis. by Gala (1994)10.1182/blood.V87.3.1140.bloodjournal8731140
/ Blood / Clinical relevance of Bcl-2 overexpression in childhood acute lymphoblastic leukemia. by Coustan-Smith (1996)10.1182/blood.V79.5.1291.bloodjournal7951291
/ Blood / Bcl-2 proto-oncogene expression in normal and neoplastic human myeloid cells. by Delia (1992)10.1182/blood.V81.11.3091.bloodjournal81113091
/ Blood / High expression of Bcl-2 protein in acute myeloid-leukemia cells is associated with poor response to chemotherapy. by Campos (1993){'key': '2019101310061304700_B33', 'first-page': '98', 'article-title': 'Bcl-2 oncoprotein expression in acute myeloid leukemia.', 'volume': '80', 'author': 'Bensi', 'year': '1995', 'journal-title': 'Haematologica'}
/ Haematologica / Bcl-2 oncoprotein expression in acute myeloid leukemia. by Bensi (1995){'key': '2019101310061304700_B34', 'first-page': '1191', 'article-title': 'Bcl-2 protein expression in normal human bone marrow precursors and in acute myelogenous leukemia.', 'volume': '9', 'author': 'Porwit-MacDonald', 'year': '1995', 'journal-title': 'Leukemia'}
/ Leukemia / Bcl-2 protein expression in normal human bone marrow precursors and in acute myelogenous leukemia. by Porwit-MacDonald (1995)10.1111/j.1365-2141.1994.tb04984.x
/ Brit J Haematol / The relationship between bcl-2 expression and response to chemotherapy in acute leukemia. by Maung (1994)10.1182/blood.V89.1.243
/ Blood / Measurement of spontaneous and therapeutic agent-induced apoptosis with Bcl-2 protein expression in acute myeloid leukemia. by Banker (1997)10.1016/S1054-3589(08)61070-4
/ Adv Pharmacol / Bcl-2 family proteins: Strategies for overcoming chemoresistance in cancer. by Reed (1997)10.1016/0092-8674(93)90508-N
/ Cell / Bcl-x, a Bcl-2-related gene that functions as a dominant regulator of apoptotic cell death. by Boise (1993)10.1242/dev.120.10.3033
/ Development / Bcl-xL is the major Bcl-x mRNA form expressed during murine development and its product localizes to mitochondria. by González-Garcia (1994){'key': '2019101310061304700_B40', 'first-page': '2576', 'article-title': 'Bcl-xL is expressed in neuroblastoma cells and modulates chemotherapy-induced apoptosis.', 'volume': '55', 'author': 'Dole', 'year': '1995', 'journal-title': 'Cancer Res'}
/ Cancer Res / Bcl-xL is expressed in neuroblastoma cells and modulates chemotherapy-induced apoptosis. by Dole (1995)10.1182/blood.V86.5.1903.bloodjournal8651903
/ Blood / Expression of Bcl-xL can confer a multidrug resistance phenotype. by Minn (1995){'key': '2019101310061304700_B42', 'first-page': '363', 'article-title': 'Overexpression of Bcl-xL by cytotoxic drug exposure confers resistance to ionizing radiation-induced internucleosomal DNA fragmentation.', 'volume': '6', 'author': 'Datta', 'year': '1995', 'journal-title': 'Cell Growth Diff'}
/ Cell Growth Diff / Overexpression of Bcl-xL by cytotoxic drug exposure confers resistance to ionizing radiation-induced internucleosomal DNA fragmentation. by Datta (1995){'key': '2019101310061304700_B43', 'first-page': '1087', 'article-title': 'Bcl-xL Overexpression inhibits taxol-induced Yama protease activity and apoptosis.', 'volume': '7', 'author': 'Ibrado', 'year': '1996', 'journal-title': 'Cell Growth Diff'}
/ Cell Growth Diff / Bcl-xL Overexpression inhibits taxol-induced Yama protease activity and apoptosis. by Ibrado (1996){'key': '2019101310061304700_B44', 'first-page': '4743', 'article-title': 'Overexpression of Bcl-2 or Bcl-xL inhibits Ara-C-induced CPP32/Yama protease activity and apoptosis of human acute myelogenous leukemia HL-60 cells.', 'volume': '56', 'author': 'Ibrado', 'year': '1996', 'journal-title': 'Cancer Res'}
/ Cancer Res / Overexpression of Bcl-2 or Bcl-xL inhibits Ara-C-induced CPP32/Yama protease activity and apoptosis of human acute myelogenous leukemia HL-60 cells. by Ibrado (1996)10.1182/blood.V89.8.2986
/ Blood / Expression and regulation of Bcl-2, Bcl-xL, and Bax correlate with p53 status and sensitivity to apoptosis in childhood acute lymphoblastic leukemia. by Findley (1997)10.1073/pnas.90.8.3516
/ Proc Natl Acad Sci USA / MCL1, a gene expressed in programmed myeloid cell differentiation, has sequence similarity to BCL-2. by Kozopas (1993){'key': '2019101310061304700_B47', 'first-page': '6348', 'article-title': 'Mcl-1, a member of the Bcl-2 family, delays apoptosis induced by c-Myc overexpression in Chinese hamster ovary cells.', 'volume': '54', 'author': 'Reynolds', 'year': '1994', 'journal-title': 'Cancer Res'}
/ Cancer Res / Mcl-1, a member of the Bcl-2 family, delays apoptosis induced by c-Myc overexpression in Chinese hamster ovary cells. by Reynolds (1994)10.1182/blood.V89.2.630
/ Blood / Mcl-1, a Bcl-2 family member, delays the death of hematopoietic cells under a variety of apoptosis-inducing conditions. by Zhou (1997)10.1016/0092-8674(93)90509-O
/ Cell / Bcl-2 heterodimerizes in vivo with a conserved homolog, Bax, that accelerates programmed cell death. by Oltvai (1993)10.1073/pnas.91.20.9238
/ Proc Natl Acad Sci USA / Interactions among members of the Bcl-2 protein family analyzed with a yeast two-hybrid system. by Sato (1994)10.1073/pnas.92.17.7834
/ Proc Natl Acad Sci USA / Multiple Bcl-2 family members demonstrate selective dimerizations with Bax. by Sedlak (1995)10.1074/jbc.271.37.22764
/ J Biol Chem / Bax can antagonize Bcl-XL during etoposide and cisplatin-induced cell death independently of its heterodimerization with Bcl-XL. by Simonian (1996){'key': '2019101310061304700_B53', 'first-page': 'S18', 'article-title': 'Association of Bcl-2, Bax, Bcl-xL and interleukein-1β converting enzyme expression with initial response to chemotherapy in acute myeloid leukemia.', 'volume': '10', 'author': 'Stoetzer', 'year': '1996', 'journal-title': 'Leukemia'}
/ Leukemia / Association of Bcl-2, Bax, Bcl-xL and interleukein-1β converting enzyme expression with initial response to chemotherapy in acute myeloid leukemia. by Stoetzer (1996){'key': '2019101310061304700_B54', 'first-page': '1309', 'article-title': 'Immunohistochemical analysis of Mcl-1 protein in human tissues.', 'volume': '146', 'author': 'Krajewski', 'year': '1995', 'journal-title': 'Am J Pathol'}
/ Am J Pathol / Immunohistochemical analysis of Mcl-1 protein in human tissues. by Krajewski (1995){'key': '2019101310061304700_B55', 'first-page': '5501', 'article-title': 'Immunohistochemical analysis of in vivo patterns of Bcl-X expression.', 'volume': '54', 'author': 'Krajewski', 'year': '1994', 'journal-title': 'Cancer Res'}
/ Cancer Res / Immunohistochemical analysis of in vivo patterns of Bcl-X expression. by Krajewski (1994)10.1074/jbc.270.44.26049
/ J Biol Chem / Overexpression of the Bcl-2 protein increases the half-life of p21Bax. by Miyashita (1995)10.1182/blood.V83.2.517.bloodjournal832517
/ Blood / Topoisomerase II levels and drug sensitivity in adult acute myelogenous leukemia. by Kaufmann (1994)10.3109/10428199609054804
/ Leuk Lymph / Addition of etoposide to initial therapy of adult ALL: A combined clinical and laboratory study. by Kaufmann (1996){'key': '2019101310061304700_B59'}
10.1182/blood.V80.3.768.bloodjournal803768
/ Blood / Bcl-2 gene expression in hematopoietic cell differentiation. by Mariano (1992)10.1182/blood.V84.2.440.bloodjournal842440
/ Blood / Dysregulated Bcl-2 expression inhibits apoptosis but not differentiation of retinoic acid-induced HL-60 granulocytes. by Park (1994)10.1016/0145-2126(95)00103-4
/ Leuk Res / Bcl-2 protein downregulation is not required for differentiation of multidrug resistant HL60 leukemia cells. by Blagosklonny (1996){'key': '2019101310061304700_B63', 'first-page': '3976', 'article-title': 'Specific proteolytic fragmentation of poly(ADP-ribose) polymerase: An early marker of chemotherapy-induced apoptosis.', 'volume': '53', 'author': 'Kaufmann', 'year': '1993', 'journal-title': 'Cancer Res'}
/ Cancer Res / Specific proteolytic fragmentation of poly(ADP-ribose) polymerase: An early marker of chemotherapy-induced apoptosis. by Kaufmann (1993)10.1182/blood.V83.5.1179.bloodjournal8351179
/ Blood / Bcr-Abl maintains resistance of chronic myelogenous leukemia cells to apoptotic cell death. by McGahon (1994){'key': '2019101310061304700_B65', 'first-page': '5870', 'article-title': 'Induction of endonucleolytic DNA cleavage in human acute myelogenous leukemia cells by etoposide, camptothecin, and other cytotoxic anticancer drugs: A cautionary note.', 'volume': '49', 'author': 'Kaufmann', 'year': '1989', 'journal-title': 'Cancer Res'}
/ Cancer Res / Induction of endonucleolytic DNA cleavage in human acute myelogenous leukemia cells by etoposide, camptothecin, and other cytotoxic anticancer drugs: A cautionary note. by Kaufmann (1989)10.1182/blood.V90.11.4283.4283_4283_4296
/ Blood / Comparison of caspase activation and subcellular localization in HL-60 and K562 cells undergoing etoposide-induced apoptosis. by Martins (1997)10.1073/pnas.92.12.5287
/ Proc Natl Acad Sci USA / Tumorigenic activity of the Bcr-Abl oncogenes is mediated by Bcl-2. by Sanchez-Garcia (1995)10.1002/(SICI)1097-4652(199603)166:3<523::AID-JCP7>3.0.CO;2-R
/ J Cell Physiol / MCL-1, a member of the BCL-2 family, is induced rapidly in response to signals for cell differentiation or death, but not to signals for cell proliferation. by Yang (1996)10.1038/sj.onc.1200927
/ Oncogene / Induction of Bcl-2 family member Mcl-1 as an early response to DNA damage. by Zhan (1997){'key': '2019101310061304700_B70', 'first-page': '5407', 'article-title': 'Bcl-2 gene transfer increases relative resistance of S49.1 and WEHI7.2 lymphoid cells to cell death and DNA fragmentation induced by glucocorticoids and multiple chemotherapeutic drugs.', 'volume': '52', 'author': 'Miyashita', 'year': '1992', 'journal-title': 'Cancer Res'}
/ Cancer Res / Bcl-2 gene transfer increases relative resistance of S49.1 and WEHI7.2 lymphoid cells to cell death and DNA fragmentation induced by glucocorticoids and multiple chemotherapeutic drugs. by Miyashita (1992){'key': '2019101310061304700_B71', 'first-page': '471', 'article-title': 'Development of a stable camptothecin-resistant subline of P388 leukemia with reduced topoisomerase I content.', 'volume': '38', 'author': 'Eng', 'year': '1990', 'journal-title': 'Mol Pharmacol'}
/ Mol Pharmacol / Development of a stable camptothecin-resistant subline of P388 leukemia with reduced topoisomerase I content. by Eng (1990){'key': '2019101310061304700_B72'}
10.1038/sj.leu.2400557
/ Leukemia / Co-expression of several molecular mechanisms of multidrug resistance and their significance for paclitaxel cytotoxicity in human AML HL-60 cells. by Huang (1997)10.1182/blood.V85.1.186.bloodjournal851186
/ Blood / Increased expression of the multidrug resistance-associated protein gene in relapsed acute leukemia. by Schneider (1995)
Dates
Type | When |
---|---|
Created | 5 years, 10 months ago (Oct. 13, 2019, 10:06 a.m.) |
Deposited | 2 years, 11 months ago (Oct. 1, 2022, 12:05 p.m.) |
Indexed | 2 days, 16 hours ago (Sept. 3, 2025, 6:40 a.m.) |
Issued | 27 years, 7 months ago (Feb. 1, 1998) |
Published | 27 years, 7 months ago (Feb. 1, 1998) |
Published Print | 27 years, 7 months ago (Feb. 1, 1998) |
@article{Kaufmann_1998, title={Elevated Expression of the Apoptotic Regulator Mcl-1 at the Time of Leukemic Relapse}, volume={91}, ISSN={0006-4971}, url={http://dx.doi.org/10.1182/blood.v91.3.991.991_991_1000}, DOI={10.1182/blood.v91.3.991.991_991_1000}, number={3}, journal={Blood}, publisher={American Society of Hematology}, author={Kaufmann, Scott H. and Karp, Judith E. and Svingen, Phyllis A. and Krajewski, Stan and Burke, Philip J. and Gore, Steven D. and Reed, John C.}, year={1998}, month=feb, pages={991–1000} }