The diverse effect of topoisomerase I specific inhibitor (camptothecin) on normal and BCR/ABL-dependent hematopoietic cells proliferation: therapeutic implications.

Camptothecin (CPT), a specific topoisomerase I inhibitor, in the presence of hematopoietic growth factors exerted an antiproliferative effect against normal bone marrow cells (NBMC) as well as chronic myelogenous leukemia-chronic phase (CML-CP) and blast crisis (CML-BC) cells. In the absence of growth factors, however, only the colony formation by CML-BC cells was inhibited by CPT, leaving NBMC and CML-CP cells intact or much less affected. Analysis of the cellular DNA content revealed that CPT induced specific changes in cell cycle distribution: decrease in S and G2/M fraction with simultaneous accumulation of the cells in G1 phase and the appearance of "sub-diploid" (apoptotic) peak. To determine if CPT is able to exert selective antileukemic effect, 1:1 mixture of NBMC and CML-BC cells was exposed to CPT in the absence of growth factors and assayed for growth ability in clonogenic assay and for expression of BCR/ABL transcript in single colonies. BCR/ABL transcript was not detected in colonies incubated with CTP, in contrast, most of colonies arising from untreated cells possessed leukemic origin (BCR/ABL expression). Our results indicate that CPT is selectively effective in vitro against the leukemia cells. This offers the prospect of a novel and more selective treatment of CML.