Erythropoietin inhibits chemotherapy-induced cell death and promotes a senescence-like state in leukemia cells

Cell Death Dis. 2019 Jan 8;10(1):22. doi: 10.1038/s41419-018-1274-6.

Abstract

There are conflicting reports on the adverse effects of erythropoietin (EPO) for the management of cancer-associated anemia. The recognition that erythropoietin receptors (EPORs) are expressed outside the erythroid lineage and concerns that erythropoiesis-stimulating agents (ESAs) may cause tumors to grow and increase the risk of venous thromboembolism have resulted in substantially fewer cancer patients receiving ESA therapy to manage myelosuppressive chemotherapy. In this study, we found that EPO suppresses p53-dependent apoptosis induced by genotoxic (daunorubicin, doxorubicin, and γ-radiation) and non-genotoxic (nutlin-3a) agents and induces a senescence-like state in myeloid leukemia cells. EPO interferes with stress-dependent Mdm2 downregulation and leads to the destabilization of p53 protein. EPO selectively modulates the expression of p53 target genes in response to DNA damage preventing the induction of a number of noncoding RNAs (ncRNAs) previously associated with p53-dependent apoptosis. EPO also enhances the expression of the cyclin-dependent kinase inhibitor p21WAF1 and promotes recruitment of p53 to the p21 promoter. In addition, EPO antagonizes Mcl-1 protein degradation in daunorubicin-treated cells. Hence, EPO signaling targets Mcl-1 expression and the p53-Mdm2 network to promote tumor cell survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antibiotics, Antineoplastic / pharmacology*
  • Apoptosis / drug effects*
  • Cell Line, Tumor
  • Cell Survival / drug effects
  • Cellular Senescence / drug effects*
  • Cyclin-Dependent Kinase Inhibitor p27 / metabolism
  • DNA Damage / drug effects
  • DNA Damage / radiation effects
  • Daunorubicin / pharmacology*
  • Doxorubicin / pharmacology*
  • Erythropoietin / pharmacology*
  • Humans
  • Leukemia / drug therapy*
  • Leukemia / pathology
  • Mice
  • Myeloid Cell Leukemia Sequence 1 Protein / metabolism
  • Proto-Oncogene Proteins c-mdm2 / metabolism
  • Tumor Suppressor Protein p53 / genetics
  • Tumor Suppressor Protein p53 / metabolism

Substances

  • Antibiotics, Antineoplastic
  • CDKN1B protein, human
  • Cdkn1b protein, mouse
  • EPO protein, human
  • Myeloid Cell Leukemia Sequence 1 Protein
  • TP53 protein, human
  • Trp53 protein, mouse
  • Tumor Suppressor Protein p53
  • Erythropoietin
  • Cyclin-Dependent Kinase Inhibitor p27
  • Doxorubicin
  • MDM2 protein, human
  • Mdm2 protein, mouse
  • Proto-Oncogene Proteins c-mdm2
  • Daunorubicin