The efficient engraftment in immunedeficient mice achieved with both acute lymphoblastic leukemia (ALL) cell lines and primary samples has facilitated identification of the antileukemia activity of a wide variety of agents. Despite widespread usage, however, little is known about the early ALL localization and engraftment kinetics in this model, limiting experimental read-outs primarily to survival and endpoint analysis at high disease burden. In this study, we report that bioluminescent imaging can be reproducibly achieved with primary human ALL samples. This approach provides a noninvasive, longitudinal measure of leukemia burden and localization that enhances the sensitivity of treatment response detection and provides greater insight into the mechanism of action of antileukemia agents. In addition, this study reveals significant cell line-and species-related differences in leukemia migration, especially early in expansion, which may confound observations between various leukemia models. Overall, this study demonstrates that the use of bioluminescent primary ALL allows the detection and quantitation of treatment effects at earlier, previously unquantifiable disease burdens and thus provides the means to standardize and expedite the evaluation of anti-ALL activity in preclinical xenograft studies. (Blood. 2011;118(15): e112-e117)
IntroductionMurine leukemia models have been useful and versatile tools for identifying and targeting underlying disease mechanisms. 1 However, preclinical studies involving human samples are more immediately applicable when investigating new drugs or therapies. Initial studies with human leukemia in immune-deficient mice, such as the NOD/SCID (NOD.CB17-Prkdc scid /J), were a great step forward and remain valuable for rapid iterations in the study of novel therapies at the preclinical level. 2,3 More recently, use of severely immune-deficient NOD/SCID/â„c ÏȘ/ÏȘ (NSG; NOD.Cg-Prkdc scid / IL2rg tm1Wjl /SzJ and NOG; NOD.Cg-Prkdc scid /Il2rgt m1Sug /Jic) mice, which lack functional B, T, and NK cells, has allowed for more consistent and reproducible engraftment of normal human cells and primary leukemias. [4][5][6] Primary acute lymphoblastic leukemia (ALL) xenografts in immune-deficient mice accurately represent human disease and gene expression and may have predictive value for clinical variables, such as drug resistance and time to relapse. [7][8][9][10][11] Although this model is a powerful and widely used tool for the ongoing development of new drugs and biologic therapeutics for ALL, [12][13][14][15][16][17][18][19] the kinetics of every primary patient sample are different, some engrafting in 4 weeks and others taking as long as one year, when measured by the appearance of human ALL blasts in peripheral blood. 5,10,20 The endpoints of these studies are typically limited to survival analysis and time to grossly detectable disease. Monitoring the peripheral blood compartment for blasts is the primary method of disease detection, leaving the early engraftment kinetics and localization, t...