Abstract

BackgroundTP53 mutations occur in only about 3% of primary and 10–20% of relapse B-cell precursor acute lymphoblastic leukaemia (BCP-ALL). However, alternative mechanisms may contribute to functionally impairing the p53 pathway in the absence of a mutation. Candidate mechanisms include overexpression of p53 mRNA variants encoding either dominant-negative p53 protein isoforms such as Delta40p53 and Delta133p53, or modulatory isoforms such as p53beta, which counteract the effects of Delta133p53 on replicative senescence in T-lymphocytes.MethodsWe used semi-quantitative reverse-transcriptase PCR (RT-PCR) and Western blot to investigate the expression of full length p53 (TAp53), Delta40p53, Delta133p53 or p53beta in diagnostic marrow from a clinical cohort of 50 BCP-ALL patients without TP53 mutation (29 males and 21 females, age range 2–14 years) and in the bone marrow cells of 4 healthy donors (used as controls).ResultsIrrespective of isoforms, levels of p53 mRNA were low in controls but were increased by 2 to 20-fold in primary or relapse BCP-ALL. TAp53 was increased in primary BCP-ALL, Delta40p53 was elevated in relapse BCP-ALL, whereas Delta133p53 and p53beta were increased in both. Next, mRNA levels were used as a basis to infer the ratio between protein isoform levels. This inference suggested that, in primary BCP-ALL, p53 was predominantly in active oligomeric conformations dominated by TAp53. In contrast, p53 mostly existed in inactive quaternary conformations containing ≥2 Delta40 or Delta133p53 in relapse BCP-ALL. Western blot analysis of blasts from BCP-ALL showed a complex pattern of N-terminally truncated p53 isoforms, whereas TAp53beta was detected as a major isoform. The hypothesis that p53 is in an active form in primary B-ALL was consistent with elevated level of p53 target genes CDKN1A and MDM2 in primary cases, whereas in relapse BCP-ALL, only CDKN1A was increased as compared to controls.ConclusionExpression of p53 isoforms is deregulated in BCP-ALL in the absence of TP53 mutation, with increased expression of alternative isoforms in relapse BCP-ALL. Variations in isoform expression may contribute to functional deregulation of the p53 pathway in BCP-ALL, specifically contributing to its down-regulation in relapse forms.

Highlights

  • TP53 mutations occur in only about 3% of primary and 10–20% of relapse B-cell precursor acute lymphoblastic leukaemia (BCP-Acute lymphoblastic leukaemia (ALL))

  • In primary B-cell precursor acute lymphoblastic leukaemia (BCP-ALL), TAp53 mRNA showed a median foldinduction of about 8.66, which was not seen in relapse BCP-ALL

  • BCP-ALL as compared to healthy donors, whereas only CDKN1A mRNA but not MDM2 was increased in relapse BCP-ALL (Fig. 1b). These results suggest that changes in the expression of p53 isoforms occur in Bone marrow mononuclear cells (BMMC) from primary and relapse BCP-ALL patients as compared to healthy donors

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Summary

Introduction

TP53 mutations occur in only about 3% of primary and 10–20% of relapse B-cell precursor acute lymphoblastic leukaemia (BCP-ALL). Acute lymphoblastic leukaemia (ALL) is the commonest childhood cancer. ALL accounts for more than 75% of childhood leukaemia, occurring more frequently in Blineage than T-lineage, with a peak prevalence in children aged 3 to 5 years. It identifies up to 9 subtypes, characterized by either specific chromosomal translocations or rearrangements, and by ploidy status [1]. These subtypes are associated with different therapeutic responses and risks of disease progression. Despite initial treatment response, disease relapse occurs in 10–15% of patients and is one of the leading causes of cancer mortality in children [2]

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