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Bistué-Rovira À, Rico LG, Bardina J, Juncà J, Granada I, Bradford JA, Ward MD, Salvia R, Solé F, Petriz J. Persistence of Chronic Lymphocytic Leukemia Stem-like Populations under Simultaneous In Vitro Treatment with Curcumin, Fludarabine, and Ibrutinib: Implications for Therapy Resistance. Int J Mol Sci 2024; 25:1994. [PMID: 38396682 PMCID: PMC10888954 DOI: 10.3390/ijms25041994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/11/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
Leukemic stem cells (LSCs) possess similar characteristics to normal hematopoietic stem cells, including self-renewal capacity, quiescence, ability to initiate leukemia, and drug resistance. These cells play a significant role in leukemia relapse, persisting even after apparent remission. LSCs were first described in 1994 by Lapidot et al. Although they have been extensively studied in acute leukemia, more LSC research is still needed in chronic lymphocytic leukemia (CLL) to understand if reduced apoptosis in mature cells should still be considered as the major cause of this disease. Here, we provide new evidence suggesting the existence of stem-like cell populations in CLL, which may help to understand the disease as well as to develop effective treatments. In this study, we identified a potential leukemic stem cell subpopulation using the tetraploid CLL cell line I83. This subpopulation is characterized by diploid cells that were capable of generating the I83 tetraploid population. Furthermore, we adapted a novel flow cytometry analysis protocol to detect CLL subpopulations with stem cell properties in peripheral blood samples and primary cultures from CLL patients. These cells were identified by their co-expression of CD19 and CD5, characteristic markers of CLL cells. As previously described, increased alkaline phosphatase (ALP) activity is indicative of stemness and pluripotency. Moreover, we used this method to investigate the potential synergistic effect of curcumin in combination with fludarabine and ibrutinib to deplete this subpopulation. Our results confirmed the effectiveness of this ALP-based analysis protocol in detecting and monitoring leukemic stem-like cells in CLL. This analysis also identified limitations in eradicating these populations using in vitro testing. Furthermore, our findings demonstrated that curcumin significantly enhanced the effects of fludarabine and ibrutinib on the leukemic fraction, exhibiting synergistic effects (combination drug index, CDI 0.97 and 0.37, respectively). Our results lend support to the existence of potential stem-like populations in CLL cell lines, and to the idea that curcumin could serve as an effective adjuvant in therapies aimed at eliminating these populations and improving treatment efficacy.
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Affiliation(s)
- Àngel Bistué-Rovira
- Departament de Farmacologia, Terapèutica i Toxicologia, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallès, Spain;
| | - Laura G. Rico
- Germans Trias i Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona (UAB), 08916 Badalona, Spain; (L.G.R.); (R.S.)
| | - Jorge Bardina
- Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Jordi Juncà
- MDS Group, Institut de Recerca Contra la Leucèmia Josep Carreras, 08916 Badalona, Spain; (J.J.); (I.G.); (F.S.)
| | - Isabel Granada
- MDS Group, Institut de Recerca Contra la Leucèmia Josep Carreras, 08916 Badalona, Spain; (J.J.); (I.G.); (F.S.)
| | - Jolene A. Bradford
- Thermo Fisher Scientific, Fort Collins, CO 80524, USA; (J.A.B.); (M.D.W.)
| | - Michael D. Ward
- Thermo Fisher Scientific, Fort Collins, CO 80524, USA; (J.A.B.); (M.D.W.)
| | - Roser Salvia
- Germans Trias i Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona (UAB), 08916 Badalona, Spain; (L.G.R.); (R.S.)
| | - Francesc Solé
- MDS Group, Institut de Recerca Contra la Leucèmia Josep Carreras, 08916 Badalona, Spain; (J.J.); (I.G.); (F.S.)
| | - Jordi Petriz
- Germans Trias i Pujol Research Institute (IGTP), Universitat Autònoma de Barcelona (UAB), 08916 Badalona, Spain; (L.G.R.); (R.S.)
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Rico LG, Salvia R, Ward MD, Bradford JA, Petriz J. Flow-cytometry-based protocols for human blood/marrow immunophenotyping with minimal sample perturbation. STAR Protoc 2021; 2:100883. [PMID: 34693361 PMCID: PMC8517606 DOI: 10.1016/j.xpro.2021.100883] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This protocol provides instructions to improve flow cytometry analysis of marrow/peripheral blood cells by avoiding erythrolytic solutions, density gradients, and washing steps. We describe two basic approaches for identifying cell surface antigens with minimal sample perturbation, which have been successfully used to identify healthy and pathologically rare cells. The greatest advantage of these approaches is that they minimize the unwanted effect caused by sample preparation, allowing for improved study of live cells at the point of analysis. For complete details on the use and execution of this protocol, please refer to Petriz et al. (2018). Optimized protocol to identify cell surface antigens with minimal sample perturbation Efficient identification of target cells avoiding artifacts from erythrolytic solutions Suitable for the simultaneous phenotypic and functional analysis of blood/marrow cells Detailed gating strategies to discriminate nucleated from non- nucleated cells
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Affiliation(s)
- Laura G Rico
- Functional Cytomics Lab, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - Roser Salvia
- Functional Cytomics Lab, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | | | | | - Jordi Petriz
- Functional Cytomics Lab, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
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Is alkaline phosphatase the smoking gun for highly refractory primitive leukemic cells? Oncotarget 2016; 7:72057-72066. [PMID: 27732563 PMCID: PMC5342144 DOI: 10.18632/oncotarget.12497] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 09/29/2016] [Indexed: 11/25/2022] Open
Abstract
With the aim to detect candidate malignant primitive progenitor populations, we modified an original alkaline phosphatase (ALP) stem cell detection method based on the identification of alkaline phosphatase fluorescent cells in combination with flow cytometry immunophenotyping. Over a period of one year, we have been using this technique to study its activity in patients with leukemia and lymphoma, showing that changes in the alkaline phosphatase levels can be used to detect rare populations of highly refractory malignant cells. By screening different blood cancers, we have observed that this activity is not always restricted to CD34+ leukemic cells, and can be overexpressed in CD34 negative leukemia. We have verified that this method gives accurate and reproducible measurements and our preliminary results suggest that CD34+/ALPhigh cells appear to sustain leukemogenesis over time.
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