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1338 Downregulation of Mir-142 Promotes Leukemia Growth in Philadelphia Chromosome-Positive (Ph+) Acute Lymphoblastic Leukemia (ALL): A Possible Novel Therapeutic Target?

Program: Oral and Poster Abstracts
Session: 603. Oncogenes and Tumor Suppressors: Poster I
Hematology Disease Topics & Pathways:
ALL, Diseases, Leukemia, Lymphoid Malignancies
Saturday, December 1, 2018, 6:15 PM-8:15 PM
Hall GH (San Diego Convention Center)

Huafeng Wang1,2*, Bin Zhang, PhD2*, Wei-Le Wang, BS3*, Dandan Zhao, MD2*, Ling Li, PhD2, Herman Wu, BS2*, Le Xuan Truong Nguyen, PhD2*, Weixu Meng, MD, PhD2*, Tinisha McDonald, MS2*, Flavia Pichiorri, PhD2, Ya-Huei Kuo, PhD2, Jianjun Chen, PhD4, Nadia Carlesso, MD, PhD2, Ibrahim Aldoss, MD2, Vinod A. Pullarkat, MD2, Monzr Al Malki, MD2, Anthony S. Stein, MD2, Mark Boldin, MD, PhD3*, Jie Jin, MD, PhD1 and Guido Marcucci, MD2

1Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
2Gehr Family Center for Leukemia Research, Department of Hematologic Malignancies Translational Science, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Medical Center, Duarte, CA
3Department of Molecular&Cellular Biology, Beckman Research Institute, City of Hope Medical Center, Duarte, CA
4Department of Systems Biology, Beckman Research Institute, City of Hope Medical Center, Duarte, CA

The Philadelphia (Ph) chromosome or t(9;22) results in the generation of a fusion gene, namely BCR/ABL1, which encodes a chimeric protein with aberrant tyrosine kinase activity that drives leukemia cell growth and survival. This molecular/cytogenetic aberration occurs in ~20%-30% of ALL cases and confers poor prognosis. Ph+ ALL patients (pts) are often referred for allogeneic hematopoietic stem cell transplantation (alloHCT), although more recently BCR-ABL–specific tyrosine-kinase inhibitors (TKIs) and immunotherapeutic approaches seemingly induced long-term remission in some patients. Nevertheless, it is still a challenge to determine which Ph+ ALL of the pts could be treated more conservatively without alloHCT. Thus identification of new prognostic biomarkers and/or therapeutic targets may be helpful. Regulation of short non-coding microRNAs(miRNAs) associated with initiation and progression of acute leukemia has been reported. miR-142(both miR-142-3p and miR-142-5p) is expressed at a relatively high level in hematopoietic tissue, and plays a role in myeloid lineage differentiation. In fact, low miR-142-3p expression was associated with myeloid differentiation failure, and miR-142 mutations was reported to promote acute myeloid leukemia (AML). More recently, Kramer et al demonstrated a role of miR-142 in lymphopoiesis by showing that miR-142 deficiency impaired B cell production in a miR-142 knock-out(ko) mouse model (Blood. 2015).

Here, we first investigated if miR-142 levels were altered in ALL pts. Analysis of a publically available miRNA expression dataset(GSE23024) showed lower level of miR-142-3p, but not miR-142-5p in Ph+ ALL pts(n=10) vs. healthy donors(n=7;p=0.0093); while no significant differences were observed in Ph- pre-B ALL pts(n=61) vs. healthy donors (n=7). In ALL Tg(P190-BCR/ABL) transgenic mice(Ph+ ALL; Nature. 1990), we found bone marrow (BM) miR-142-3p level to be ~2.3-fold lower than those in the wild-type (wt) controls(p=0.036). Compared to wt mice, Ph+ ALL mice showed significantly lower miR-142-3p level in all the immunophenotypically identified BM lymphoid subpopulations, including progenitor B (pro-B, B220+CD19+CD43+IgM-,~19.1-fold lower,p<0.0001), precursor B (pre-B, B220+CD19+CD43-IgM-,~9.7-fold lower, p<0.0001), and other immature B (B220lowCD19+CD43-IgM+, ~2.4-fold lower, p<0.001) cells, except for mature B (B220highCD19+CD43-IgM+) cells. Ph+ ALL mice exhibited a miR-142-3p gradient expression pattern following the lymphoid differentiation hierarchy, with the lowest levels found in the pro-B and pre-B populations. These results prompted us to hypothesize that, loss of miR-142 may contribute to primitive B cell expansion possibly due to B cell differentiation blockage in Ph+ ALL mice. To prove this, we crossed miR-142 double knock-out (d-ko)mice with Ph+ ALL mice to generate miR-142(ko)Tg(P190-BCR/ABL) mice. Homozygous miR-142(d-ko)Tg(P190-BCR/ABL) mice were not viable due to an overly aggressive leukemia phenotype. Heterozygous miR-142(wt/ko)Tg(P190-BCR/ABL) mice had evidence of more rapid expansion of pro-B cells in blood(PB; 47.9% vs. 9.8%, p<0.0001), BM (48.2% vs. 13.2%, p<0.01)and spleen(32.3%vs. 4.4%, p<0.01) at 6 weeks old and a significantly reduced survival(median survival 44 vs.80 days, p<0.0001), compared to miR-142(wt/wt)Tg(P190-BCR/ABL) controls. BM cells (CD45.2) from miR-142(wt/ko)Tg(P190-BCR/ABL) mice (n=4) or miR-142(wt/wt)Tg(P190-BCR/ABL) mice (n=5) were then transplanted into congenic CD45.1 recipient mice (n=18 and n=15 respectively).Recipients of BM cells from miR-142(wt/ko)Tg(P190-BCR/ABL) donors showed increased engraftment (94% vs. 77% in PB at 4 weeks, p<0.0001) and significantly reduced survival(median survival 25 vs. 49 days, p<0.0001), as compared with recipients of BM cells from miR-142(wt/wt)P190-BCR-ABL mice. Finally, upon ex vitro exposure to the TKI nilotinib (5uM for 48 hours), miR-142(wt/ko)Tg(P190-BCR/ABL) BM cells showed reduced apoptosis (7.0% vs.37.5% vs p<0.05) and increased cell viability (66% vs.16.2%, p<0.05) compared with miR-142 (wt/wt)Tg(P190-BCR/ABL) BM cells. In vivo treatment studies with TKI treatment are ongoing and data will be presented at the meeting. In conclusion, miR-142 downregulation promotes rapid Ph+ ALL growth likely by contributing to a blockage of B cell differentiation, and may mediate resistance to TKIs.

Disclosures: Stein: Celgene: Speakers Bureau; Amgen Inc.: Speakers Bureau. Jin: The National Natural Science Foundation of China: Research Funding; College of Medicine, Zhejiang University: Employment.

*signifies non-member of ASH