Original Article

Citation: Blood Cancer Journal (2015) 5, e307; doi:10.1038/bcj.2015.31
Published online 17 April 2015

Drug screen in patient cells suggests quinacrine to be repositioned for treatment of acute myeloid leukemia

A Eriksson1, A Österroos1, S Hassan1, J Gullbo2, L Rickardson1, M Jarvius1, P Nygren2, M Fryknäs1, M Höglund1 and R Larsson1

  1. 1Department of Medical Sciences, Uppsala University, Uppsala, Sweden
  2. 2Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden

Correspondence: Professor R Larsson, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. E-mail: rolf.larsson@medsci.uu.se

Received 24 February 2015; Accepted 6 March 2015



To find drugs suitable for repositioning for use against leukemia, samples from patients with chronic lymphocytic, acute myeloid and lymphocytic leukemias as well as peripheral blood mononuclear cells (PBMC) were tested in response to 1266 compounds from the LOPAC1280 library (Sigma). Twenty-five compounds were defined as hits with activity in all leukemia subgroups (<50% cell survival compared with control) at 10 μM drug concentration. Only one of these compounds, quinacrine, showed low activity in normal PBMCs and was therefore selected for further preclinical evaluation. Mining the NCI-60 and the NextBio databases demonstrated leukemia sensitivity and the ability of quinacrine to reverse myeloid leukemia gene expression. Mechanistic exploration was performed using the NextBio bioinformatic software using gene expression analysis of drug exposed acute myeloid leukemia cultures (HL-60) in the database. Analysis of gene enrichment and drug correlations revealed strong connections to ribosomal biogenesis nucleoli and translation initiation. The highest drug–drug correlation was to ellipticine, a known RNA polymerase I inhibitor. These results were validated by additional gene expression analysis performed in-house. Quinacrine induced early inhibition of protein synthesis supporting these predictions. The results suggest that quinacrine have repositioning potential for treatment of acute myeloid leukemia by targeting of ribosomal biogenesis.