1. ¹Department of Pediatrics, School of Medicine, University of Yamanashi, Yamanashi, Japan
2. ²Bioinformatics Support Section, Center for Life Science Research, University of Yamanashi, Yamanashi, Japan
3. ³Department of Immunology, Juntendo University School of Medicine, Tokyo, Japan
4. ⁴Laboratory of Immunology, Saitama Shakaihoken Hospital, Saitama, Japan

Correspondence: Dr T Inukai, Department of Pediatrics, School of Medicine, University of Yamanashi, Chuo City, Yamanashi 409-3898, Japan. E-mail: tinukai@yamanashi.ac.jp

⁵These authors contributed equally to this work.

Received 24 December 2005; Revised 2 September 2006; Accepted 6 September 2006; Published online 26 October 2006.

Abstract

Malignant cells generally acquire some immune escape mechanisms for clonal expansion. Immune escape mechanisms also contribute to the failure of graft-versus-leukemia (GVL) effect after allogeneic hematopoietic stem cell transplantation (allo-SCT). Infant leukemias with mixed-lineage leukemia (MLL) rearrangement have a remarkably short latency, and GVL effect after allo-SCT has not been clearly evidenced in these leukemias. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)- and FasL-mediated cytotoxic pathways play important roles in cytotoxic T-lymphocyte- and natural killer cell-mediated antitumor immunity and optimal GVL activity. We investigated the in vitro sensitivity of MLL-rearranged acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) cells to TRAIL- and FasL-mediated cytotoxicity. Most of cell lines and primary leukemia cells were highly resistant to TRAIL primarily owing to low cell-surface expression of death receptors in ALL and simultaneous expression of decoy receptors in AML. Nearly half of cell lines and majority of primary leukemia cells showed low sensitivity to FasL. These results suggest that resistance to death-inducing ligands, particularly to TRAIL, could be one of the mechanisms for a rapid clonal expansion and a poor sensitivity to the GVL effect in infant leukemias with MLL rearrangement.