Abstract
Chronic myelogenous leukemia (CML) is caused by the reciprocal chromosomal translocation t(9:22)(q34;q11). This translocation yields BCR-ABL fusion gene on derivative chromosome 22 called as Philadelphia (Ph) chromosome. Although several forms of BCR-ABL are generated according to the breakpoints in the BCR gene, p210 BCR-ABL is observed in more than 95 % of CML patients. In contrast to the nuclear localization of c-ABL, BCR-ABL is localized in the cytoplasm and acts as a constitutively active tyrosine kinase as a tetramer. BCR-ABL has several functional domains, through which it interacts with downstream signaling molecules and transmits leukemogenic signals: a coiled-coil motif, SH2 domain, Y177, and Dbl homology domain from BCR and SH3, SH2, SH1(kinase), CRKL-binding, and actin-binding domains from c-ABL. Through these domains, BCR-ABL activates Ras/MAPK, PI3K/Akt, and STATs, each of which contributes to excessive cell growth, survival, and consequent leukemic transformation. In addition, SHP-2, c-Cbl, Gab2, and CRKL are involved in the leukemogenic activities of BCR-ABL. Although tyrosine kinase inhibitors (TKIs) have dramatically improved the prognosis of CML patients in chronic phase, a small proportion of patients show resistance to TKIs due to point mutations of the BCR-ABL gene and/or BCR-ABL-independent activation of Src family tyrosine kinases such as Lyn and HCK. In addition, CML stem cells are known to resistant to TKIs, in which JAK2, Wnt/β-catenin, and Sonic hedgehog pathways are activated in a BCR-ABL independent manner and contribute to TKI resistance.
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Matsumura, I. (2016). Roles for Signaling Molecules in the Growth and Survival of CML Cells. In: Kizaki, M. (eds) Molecular Pathogenesis and Treatment of Chronic Myelogenous Leukemia. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55714-2_3
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