Bruton's tyrosine kinase (BTK) deficiency results in a differentiationpre-B cell receptor ͉ differentiation block ͉ apoptosis R ecent findings by us and others (1, 2) suggested a role for the pre-B cell receptor and related signaling molecules as a tumor suppressor to prevent the development or limit the proliferation of leukemic cells. BCR-ABL1 ϩ pre-B lymphoblastic leukemia cells frequently exhibit defective expression of the pre-B cell receptor related signaling molecule SLP65 (1) and acquire independence from pre-B cell receptor-dependent survival signals (2). The analysis of mouse mutants of the pre-B cell receptor-related signaling molecules SLP65 and Bruton's tyrosine kinase (BTK) demonstrated that SLP65 and BTK cooperate to suppress leukemic transformation (3).Pre-B lymphoblastic leukemia cells typically exhibit a differentiation block at the pre-B cell stage of development (2); likewise, BTK deficiency in humans leading to X-linked agammaglobulinemia results in a breakdown of pre-B cell receptor signals and a differentiation block at the pre-B cell stage (4). To elucidate a possible role for BTK in leukemic transformation of human B cell precursors, we investigated BTK function in pre-B acute lymphoblastic leukemia cells.
Materials and MethodsPatient Samples, Cell Lines, and Cell Purification. Normal CD19 ϩ -chain Ϫ pro-B cells and CD19 ϩ VpreB ϩ pre-B cells were sorted from human bone marrow from four healthy donors (purchased from Cambrex, Baltimore) by using immunomagnetic beads against CD19 (Miltenyi Biotech, Bergisch Gladbach, Germany) and cell sorting using antibodies against CD19, VpreB (BD Biosciences, Heidelberg, Germany), and the -chain (Jackson ImmunoResearch). Similarly, CD5 ϩ CD19 ϩ B1 cells, IgD ϩ CD27 Ϫ naïve B cells, CD19 ϩ CD27 ϩ memory B cells, and CD19 ϩ CD138 ϩ plasma cells were sorted from peripheral blood of four healthy donors by using antibodies against CD5, CD19, CD27, CD138, and IgD (BD Biosciences).In total, 29 B cell precursor leukemias including 12 cell lines and 17 primary cases were studied. Eleven cases of B cell precursor leukemia with MLL-AF4 gene rearrangement [t (4, 11)(q21;q23)] including eight primary cases (I-VIII, Table 1, which is published as supporting information on the PNAS web site) and three cell lines (BEL1, RS4;11, and SEM) were analyzed. Eleven samples carrying a BCR-ABL1 gene rearrangement [t (9, 22)(q34;q11)] including seven primary cases (IX-XV, Table 1) and four cell lines (BV173, Nalm1, SD1, and SUP-B15) were studied. In addition, three leukemia cell lines carrying an E2A-PBX1 gene rearrangement [t (1, 19) (q23;p13); 697, Kasumi2, and MHH-CALL3], three cases of pre-B lymphoblastic leukemia with TEL-AML1 fusion gene [t (12, 21)(p12;q22)] including two primary cases (XVIII and XIX, Table 1), and the cell line REH and one pre-B lymphoblastic leukemia cell line harboring a TEL-PDGFRB gene rearrangement [Nalm6; t (5, 12)(q33.2;p13.2)] were studied. For all cases, fusion transcripts resulting from oncogenic gene rearrangements were detected by PCR as desc...