0 d ially treated with hydroxyurea (HU) and interferon alpha IFN). Response to treatment was poor and in the 21st month fter diagnosis the disease accelerated. Intensive chemotherpy with the FLAM/FLAG regimen (fludarabine, cytosine rabinoside and mitoxantrone/G-CSF) was started followed ith crossover to imatinib (IM). After initial complete hemaologic response to IM, lasting for 7 weeks, the patient elapsed again and the disease rapidly progressed to blast risis. Gene expression profiling in the course of the disease as performed using 5 DB Biosciencase’s AtlasTM Human ancer cDNA Expression Arrays with a set of 588 genes. aw data obtained with Clontech’s Atlas ImageTM 15 softare were log transformed and hierarchical clustering was genes, Fig. 1B2). The expression patterns of these two accelerations resemble each other; however, one must bear in mind that the analysis of the second acceleration was performed not from chronic phase, but from the early accelerated phase following complete hematological response. Examples of products of genes in these two clusters are members of ECM molecules, collagens and procollagens (COL11A1, 11A2, 4A2, 16A1, 8A1, 3A1, 1A2 and 2A1) and laminins (LAMC1, A4, B1 and B2). Also ECM binding integrins (ITGA1, A3, B1, B4, B5 and B6), with ITGA3 already described to be up-regulated in CML cells [4], belong to this group. Other members of these clusters are vascular endothelial growth factor receptors (VEGFR2 and 3), known to play a role in leukemias including CML [5]. Also cyclin C and cyclin D1 erformed with average linking clustering and Euclidian disance measurement using Genesis software [1]. Disease charcteristics at the time of array analyses are given in Table 1. The results show that three types of gene clusters can e recognized in the two CML accelerations in this patient were up-regulated in both accelerations. The results suggest that the genes from the second group may be typical for the disease acceleration. The third set of genes included groups of genes expressed differently in the first and second acceleration. The express r w e a f a i T b Fig. 1). First, genes with expression remaining up-regulated 22 genes, Fig. 1A1) or down-regulated (9 genes, Fig. 1A2), ompared to the standard, throughout the whole course of the isease. Among up-regulated genes were, e.g., collagens and nsulin-like growth factor 1 (IGF1). IGF1 is known to stimlate AML and ALL blast colony growth [2]. Among downegulated genes were, e.g., extracellular signal-regulated
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