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The homeobox gene CDX2 is aberrantly expressed in most cases of acute myeloid leukemia and promotes leukemogenesis
Claudia Scholl, … , D. Gary Gilliland, Stefan Fröhling
Claudia Scholl, … , D. Gary Gilliland, Stefan Fröhling
Published April 2, 2007
Citation Information: J Clin Invest. 2007;117(4):1037-1048. https://doi.org/10.1172/JCI30182.
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Research Article

The homeobox gene CDX2 is aberrantly expressed in most cases of acute myeloid leukemia and promotes leukemogenesis

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Abstract

The homeobox transcription factor CDX2 plays an important role in embryonic development and regulates the proliferation and differentiation of intestinal epithelial cells in the adult. We have found that CDX2 is expressed in leukemic cells of 90% of patients with acute myeloid leukemia (AML) but not in hematopoietic stem and progenitor cells derived from normal individuals. Stable knockdown of CDX2 expression by RNA interference inhibited the proliferation of various human AML cell lines and strongly reduced their clonogenic potential in vitro. Primary murine hematopoietic progenitor cells transduced with Cdx2 acquired serial replating activity, were able to be continuously propagated in liquid culture, generated fully penetrant and transplantable AML in BM transplant recipients, and displayed dysregulated expression of Hox family members in vitro and in vivo. These results demonstrate that aberrant expression of the developmental regulatory gene CDX2 in the adult hematopoietic compartment is a frequent event in the pathogenesis of AML; suggest a role for CDX2 as part of a common effector pathway that promotes the proliferative capacity and self-renewal potential of myeloid progenitor cells; and support the hypothesis that CDX2 is responsible, in part, for the altered HOX gene expression that is observed in most cases of AML.

Authors

Claudia Scholl, Dimple Bansal, Konstanze Döhner, Karina Eiwen, Brian J.P. Huntly, Benjamin H. Lee, Frank G. Rücker, Richard F. Schlenk, Lars Bullinger, Hartmut Döhner, D. Gary Gilliland, Stefan Fröhling

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Figure 5

Mouse model of aberrant Cdx2 expression.

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Hox gene expression in murine hematopoietic cells expressing Cdx2.
    ...
(A) Mice transplanted with BM cells expressing Cdx2 (n = 5) developed AML after a median of 187 days after transplantation, whereas mice transplanted with MSCV-IRES-GFP–transduced BM (n = 3) showed no evidence of disease with a follow-up duration of more than 250 days (P = 0.013). Secondary recipients (n = 5) transplanted with BM from primary leukemic mice developed AML after a median of 52 days after transplantation. BMT, BM transplantation. (B) Diseased mice showed elevated wbc counts (primary recipients versus control mice, P = 0.09; secondary recipients versus control mice, P = 0.019) and splenomegaly (primary recipients versus control mice, P = 0.0029; secondary recipients versus control mice, P < 0.0001). Values are represented as mean ± SD. (C) Microscopic analysis of PB from primary and secondary leukemic animals demonstrated leukocytosis consisting of frequent immature myeloid cells with a high proportion of blast forms that extensively involved the BM, liver, and spleen. Panels display Wright-Giemsa–stained PB smears and H&E-stained tissue sections from representative mice transplanted with BM cells expressing Cdx2. Original magnification, ×400 and ×1,000 (PB); ×100 and ×600 (BM and liver); and ×40 and ×600 (spleen). (D) Flow cytometric analysis of GFP-gated cells from BM and spleen of primary and secondary leukemic animals demonstrated an increased proportion of Mac-1+ myeloid cells with variable expression of Gr-1, CD34, and c-Kit and a concomitant reduction in the level of CD3+ or B220+ lymphoid cells. The percentages of positive cells within the GFP+ compartment are indicated.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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