Arsenic trioxide uses caspase-dependent and caspase-independent death pathways in myeloma cells

Jennifer McCafferty-Grad, Nizar J. Bahlis, Nancy Krett, Tatiana M. Aguilar, Isildinha Reis, Kelvin P. Lee, Lawrence H. Boise

Research output: Contribution to journalArticlepeer-review

56 Scopus citations


Arsenic trioxide (ATO) is emerging as a standard therapy for refractory acute promyelocytic leukemia. Consequently, ATO-based therapies are being investigated in other cancers. We have reported that the combination of ATO and ascorbic acid is an effective strategy in chemoresistant myeloma cell lines and in plasma cells from patients. ATO action is multimodal and appears to involve thiol depletion, increased reactive oxygen species production, loss of mitochondrial membrane potential (Δψm), and activation of caspases. To better define the ATO death pathway, we asked whether caspase activity is required for ATO-mediated cell death. Here we report that ATO exerts cytotoxic effects in myeloma cell lines via both caspase-dependent and caspase-independent pathways. We monitored ATO-induced changes in cell viability, caspase activity, superoxide production, and Δψm in the presence or absence of the caspase inhibitors t-butoxy carbonyl-Asp.fluoromethylketone (BocD.fmk) and Z-Val- Ala-Asp.fluoromethylketone (zVAD.fmk) and the antioxidant N-acetylcysteine. Consistent with glutathione levels dictating ATO action, N-acetylcysteine abrogated ATO-induced changes in cell death, caspase activation, free radical production, and loss of Δψm in all the cell lines we tested. Experiments with caspase inhibitors suggested at least two models for ATO death signaling. In 8226/S cells, blockade of caspases had no effect on loss of cell viability, increase in reactive oxygen species production, and minimal effects on the loss of Δψm . In contrast, BocD.fmk or zVAD.fmk conferred significant protection from the effects of ATO in U266 cells and MM1.S cells. Chemoresistant variants of 8226/S and MM1.S displayed similar ATO-induced death pathways as their respective parental lines. Studies with myeloma cells from bone marrow biopsies indicated that ATO initiates a caspase-independent pathway in the majority of samples.

Original languageEnglish (US)
Pages (from-to)1155-1164
Number of pages10
JournalMolecular cancer therapeutics
Issue number11
StatePublished - Nov 2003

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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