RESUMEN
Autologous transplantation of peripheral blood (PB) hematopoietic stem cells (HSCs) is a widely used strategy for reconstitution of blood cells following high-dose chemotherapy for hematologic malignancies such as multiple myeloma (MM), non-Hodgkin lymphoma (NHL), and acute myeloid leukemia (AML), among others. Stem cells for transplantation are usually obtained from PB after treatment with chemotherapy with or without cytokine, usually granulocyte-colony stimulating factor (G-CSF), or after treatment with cytokine alone. The use of autologous peripheral blood stem cells (PBSCs) for transplantation is associated with the risk of contamination of the graft with tumor cells; whether this impacts response rates, progression-free survival (PFS), and overall survival (OS) is still debatable. This review summarizes the controversy surrounding tumor cell mobilization (TCM), the complexity of detection of minimal residual diseases, the available diagnostic tools, differences in TCM with available mobilization regimens, and the potential effect of TCM on clinical outcome. Collectively, these data suggest that new treatment paradigms to manage hematologic malignancies, such as MM, NHL, and AML, are needed and should focus on increasing the chemosensitivity of the tumor and eliminating residual disease.
Asunto(s)
Citocinas/efectos adversos , Factor Estimulante de Colonias de Granulocitos/efectos adversos , Neoplasias Hematológicas/patología , Movilización de Célula Madre Hematopoyética/efectos adversos , Compuestos Heterocíclicos/efectos adversos , Células Neoplásicas Circulantes , Células Madre Neoplásicas/efectos de los fármacos , Trasplante de Células Madre de Sangre Periférica/efectos adversos , Trasplante Autólogo/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Bencilaminas , Biomarcadores de Tumor , Terapia Combinada , Ciclamas , Citocinas/farmacología , ADN de Neoplasias/sangre , Citometría de Flujo , Factor Estimulante de Colonias de Granulocitos/farmacología , Neoplasias Hematológicas/sangre , Neoplasias Hematológicas/tratamiento farmacológico , Neoplasias Hematológicas/mortalidad , Neoplasias Hematológicas/cirugía , Compuestos Heterocíclicos/farmacología , Humanos , Neoplasia Residual , Células Madre Neoplásicas/química , Células Madre Neoplásicas/citología , Reacción en Cadena de la Polimerasa/métodos , Recurrencia , Riesgo , Translocación Genética , Resultado del TratamientoRESUMEN
More than 10 years ago, Rheb (Ras homolog enriched in brain) was identified as a highly conserved protein that is a member of the Ras superfamily of small GTPases, which play critical roles in cell growth and proliferation. Recently, a convergence of genetic and biochemical evidence from yeast, Drosophila, and mammalian cells has placed Rheb upstream of the mammalian target of rapamycin (mTOR) and immediately downstream of the tumor suppressors TSC1 (hamartin) and TSC2 (tuberin). Rheb plays a key role in the regulation of cell growth in response to growth factors, nutrients, and amino acids linking PI3K and TOR signaling. Rheb activation of the nutrient and energy-sensitive TOR pathway leads to the direct phosphorylation of two known downstream translational control targets by mTOR, the 40S ribosomal S6 kinase 1 (S6K1) and the eukaryotic translation initiation factor 4E (eIF4E)- binding protein 1 (4E-BP1). Appropriate regulation of this pathway is crucial for the proper control of cell growth, proliferation, survival, and differentiation. Inappropriate regulation of these signaling molecules, therefore, can lead to a variety of human diseases. In this chapter, we describe cell biological and biochemical methods commonly used to study Rheb activation and dissect its role in the mTOR-signaling pathway.
Asunto(s)
Proteínas de Drosophila/fisiología , Proteínas de Unión al GTP Monoméricas/fisiología , Neuropéptidos/fisiología , Proteínas Quinasas/metabolismo , Proteínas Quinasas S6 Ribosómicas/fisiología , Animales , Proteínas Portadoras/metabolismo , Tamaño de la Célula , Drosophila , Activación Enzimática , Farnesiltransferasa/antagonistas & inhibidores , Proteínas Activadoras de GTPasa/análisis , Humanos , Péptidos y Proteínas de Señalización Intracelular , Fosfoproteínas/metabolismo , Fosforilación , Proteína Homóloga de Ras Enriquecida en el Cerebro , Ratas , Transducción de Señal , Sirolimus/farmacología , Serina-Treonina Quinasas TOR , Transfección/métodosRESUMEN
The assembly of cytoskeletal structures is coupled to other cellular processes. We have studied the molecular mechanism by which assembly of the yeast septin cytoskeleton is monitored and coordinated with cell cycle progression by analyzing a key regulatory protein kinase, Hsl1, that becomes activated only when the septin cytoskeleton is properly assembled. We first identified a regulatory region of Hsl1 that physically associates with the kinase domain and found that it performs an autoinhibitory function both in vivo and in vitro. Several septin binding domains lie near and overlap the inhibitory domain; these are important for Hsl1 function, and binding of two septins, Cdc11 and Cdc12, relieves the autoinhibition imposed by the kinase inhibitory domain in vitro. Our results suggest that binding to multiple septins activates Hsl1 kinase activity, thereby promoting cell cycle progression. The high conservation of Hsl1 indicates that similar mechanisms may monitor cytoskeletal organization in other eukaryotes.