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Review

Positive and negative regulation of apoptotic pathways by cytotoxic agents in hematological malignancies

Leukemia volume 14, pages 1833–1849 (2000)Cite this article

Abstract

Most chemotherapeutic drugs can induce tumor cell death by apoptosis. Analysis of the molecular mechanisms that regulate apoptosis has indicated that anticancer agents simultaneously activate several pathways that either positively or negatively regulate the death process. The main pathway from specific damage induced by the drug to apoptosis involves activation of caspases in the cytosol by pro-apoptotic molecules such as cytochrome c released from the mitochondrial intermembrane space. At least in some cell types, anticancer drugs also upregulate the expression of death receptors and sensitize tumor cells to their cognate ligands. The Fas-mediated pathway could contribute to the early steps of drug-induced apoptosis while sensitization to the cytokine TRAIL could be used to amplify the response to cytotoxic drugs. The Bcl-2 family of proteins, that includes anti- and pro-apoptotic molecules, regulates cell sensitivity mainly at the mitochondrial level. Anticancer drugs modulate their expression (eg through p53-dependent gene transcription), their activity (eg by phosphorylating Bcl-2) and their subcellular localization (eg by inducing the translocation of specific BH3-only pro-apoptotic proteins). Very early after interacting with tumor cells, anticancer drugs also activate lipid-dependent signaling pathways that either increase or decrease cell ability to die by apoptosis. In addition, cytotoxic agents can activate protective pathways that involve activation of NFκB transcription factor, accumulation of heat shock proteins such as Hsp27 and activation of proteins involved in cell cycle regulation. This review discusses how modulation of the balance between noxious and protective signals that regulate drug-induced apoptosis could be used to improve the efficacy of current therapeutic regimens in hematological malignancies.

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Acknowledgements

Our group is supported by grants from INSERM, the Ligue Nationale Contre le Cancer (comittees: Côte d'Or, Saône et Loire, Nièvre), the Association pour la Recherche sur le Cancer (No. 9567), the Association pour la Recherche sur la Transfusion (ART) and the Association Régionale pour l'Enseignement et la Recherche Scientifique et Technologique en Champagne-Ardenne (ARERS). ND is the recipient of a grant from the Société Française d'Hématologie.

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  1. INSERM Unité 517, Dijon, France

    E Solary, N Droin, A Bettaieb, L Corcos, M-T Dimanche-Boitrel & C Garrido

  2. Clinical Hematology Unit, CHU Le Bocage, Dijon, France

    E Solary

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  1. E Solary
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  2. N Droin
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Solary, E., Droin, N., Bettaieb, A. et al. Positive and negative regulation of apoptotic pathways by cytotoxic agents in hematological malignancies. Leukemia 14, 1833–1849 (2000). https://doi.org/10.1038/sj.leu.2401902

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