Leukemia
Normal and Malignant Hemopoiesis


January 2001, Volume 15, Issue 1, Pages 69 - 73

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Original Manuscript
Modulation of ara-CTP levels by fludarabine and hydroxyurea in leukemic cells

M Ahlmann, C Lanvers, K Lümkemann, C Rössig, A Freund, M Baumann & J Boos

Department of Pediatric Oncology, University of Münster, Albert Schweitzer Str. 33, 48129 Münster, Germany    

Correspondence to: J Boos, Fax: (0)251-83-47828    

Keywords
hydroxyurea;   fludarabine;   acute leukemia;   cytarabine;   ribonucleotide reductase inhibitors

Abstract

The rate of ara-cytosine triphosphate (ara-CTP) accumulation and its retention has been correlated with 1-beta-D-arabinofuranosylcytosine (ara-C)-mediated toxicity and clinical outcome in childhood and adult leukemia. We tested to what extent preincubation with the ribonucleotide reductase inhibitors fludarabine (F-ara-A) and hydroxyurea (HU) enhanced ara-CTP levels in two human myeloid (HL-60, CMK) and two lymphoblastic leukemia cell lines (MOLT-4, BLIN-1) and also in blasts from 28 children with acute leukemia (AML: 14, ALL: 14). Incubation experiments carried out with cell lines showed F-ara-A and HU to be equipotent in increasing ara-CTP levels. The highest increase was observed in HL-60 cells whereas preincubation had no modulatory effect in MOLT-4 cells. Accordingly, modulation of intracellular ara-CTP levels differed between the subtypes of childhood acute leukemia: whereas in T-ALL (five) preincubation with F-ara-A and HU had no effect on intracellular ara-C metabolism, increased ara-CTP levels were seen in some cases of pre-B-ALL (seven). In myelogenous blasts (12) clinically relevant enhancement of ara-C toxification was regularly obtained with both, F-ara-A (1.9-fold) and HU (1.5-fold). In conclusion, our data suggest that combinations of ara-C and ribonucleotide reductase inhibitors are apt to increase ara-CTP levels depending on the individual cell type and its sensitivity towards ara-C modulators. Leukemia (2001) 15, 69-73.

Received 2 June 2000; Accepted 31 August 2000

© Macmillan Publishers Ltd 2001