Axl, a prognostic and therapeutic target in acute myeloid leukemia mediates paracrine crosstalk of leukemia cells with bone marrow stroma
I Ben-Batalla, A Schultze, M Wroblewski… - Blood, The Journal …, 2013 - ashpublications.org
I Ben-Batalla, A Schultze, M Wroblewski, R Erdmann, M Heuser, JS Waizenegger…
Blood, The Journal of the American Society of Hematology, 2013•ashpublications.orgAcute myeloid leukemia (AML) represents a clonal disease of hematopoietic progenitors
characterized by acquired heterogenous genetic changes that alter normal mechanisms of
proliferation, self-renewal, and differentiation. Although 40% to 45% of patients younger than
65 years of age can be cured with current therapies, only 10% of older patients reach long-
term survival. Because only very few novel AML drugs were approved in the past 2 decades,
there is an urgent need to identify novel targets and therapeutic strategies to treat …
characterized by acquired heterogenous genetic changes that alter normal mechanisms of
proliferation, self-renewal, and differentiation. Although 40% to 45% of patients younger than
65 years of age can be cured with current therapies, only 10% of older patients reach long-
term survival. Because only very few novel AML drugs were approved in the past 2 decades,
there is an urgent need to identify novel targets and therapeutic strategies to treat …
Abstract
Acute myeloid leukemia (AML) represents a clonal disease of hematopoietic progenitors characterized by acquired heterogenous genetic changes that alter normal mechanisms of proliferation, self-renewal, and differentiation. Although 40% to 45% of patients younger than 65 years of age can be cured with current therapies, only 10% of older patients reach long-term survival. Because only very few novel AML drugs were approved in the past 2 decades, there is an urgent need to identify novel targets and therapeutic strategies to treat underserved AML patients. We report here that Axl, a member of the Tyro3, Axl, Mer receptor tyrosine kinase family, represents an independent prognostic marker and therapeutic target in AML. AML cells induce expression and secretion of the Axl ligand growth arrest–specific gene 6 (Gas6) by bone marrow–derived stromal cells (BMDSCs). Gas6 in turn mediates proliferation, survival, and chemoresistance of Axl-expressing AML cells. This Gas6-Axl paracrine axis between AML cells and BMDSCs establishes a chemoprotective tumor cell niche that can be abrogated by Axl-targeting approaches. Axl inhibition is active in FLT3-mutated and FLT3 wild-type AML, improves clinically relevant end points, and its efficacy depends on presence of Gas6 and Axl. Axl inhibition alone or in combination with chemotherapy might represent a novel therapeutic avenue for AML.
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