Abstract

Notch hyperactivation dominates T-cell acute lymphoblastic leukemia development, but the mechanisms underlying “pre-leukemic” cell dissemination are still unclear. Here we describe how deregulated Notch3 signaling enhances CXCR4 cell-surface expression and migratory ability of CD4+CD8+ thymocytes, possibly contributing to “pre-leukemic” cell propagation, early in disease progression. In transgenic mice overexpressing the constitutively active Notch3 intracellular domain, we detect the progressive increase in circulating blood and bone marrow of CD4+CD8+ cells, characterized by high and combined surface expression of Notch3 and CXCR4. We report for the first time that transplantation of such CD4+CD8+ cells reveals their competence in infiltrating spleen and bone marrow of immunocompromised recipient mice. We also show that CXCR4 surface expression is central to the migratory ability of CD4+CD8+ cells and such an expression is regulated by Notch3 through β-arrestin in human leukemia cells. De novo, we propose that hyperactive Notch3 signaling by boosting CXCR4-dependent migration promotes anomalous egression of CD4+CD8+ cells from the thymus in early leukemia stages. In fact, in vivo CXCR4 antagonism prevents bone marrow colonization by such CD4+CD8+ cells in young Notch3 transgenic mice. Therefore, our data suggest that combined therapies precociously counteracting intrathymic Notch3/CXCR4 crosstalk may prevent dissemination of “pre-leukemic” CD4+CD8+ cells, by a “thymus-autonomous” mechanism.

Highlights

  • Malignant transformation of T-cell progenitors is causative of T-cell acute lymphoblastic leukemia (T-ALL)

  • High CXCR4 cell-surface expression correlates with enhanced migration of N3-ICtg Double Positive (DP) thymocytes

  • We characterized the impact of the relative “fitness” of thymus-derived “pre-leukemic” DP-cells on bone marrow (BM) homing and engraftment

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Summary

Introduction

Malignant transformation of T-cell progenitors is causative of T-cell acute lymphoblastic leukemia (T-ALL). T-ALL accounts for 15% of pediatric and 25% of adult ALL cases, very frequently bearing somatic gain-of-function gene mutations in Notch, as well as overexpression of Notch3 [1,2,3]. Notch gene activating mutations have been recently reported in T-ALL [4]. Notch receptors regulate T-cell fate choices, dominating early steps of thymocyte differentiation [5, 6]. Thymocyte turnover is regulated by natural cell competition, between “young” bone marrow (BM)-derived and “old” thymus-resident progenitors, whose impairment enables T-ALL progression via pre-malignant stages [7]. A major role is played by the interaction between leukemia and nonleukemia cells in the microenvironment, probably dictating the survival of leukemia initiating cells

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