LEF-1 is a prosurvival factor in chronic lymphocytic leukemia and is expressed in the preleukemic state of monoclonal B-cell lymphocytosis by Albert Gutierrez,

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LEF-1 is a prosurvival factor in chronic lymphocytic leukemia and is expressed in the preleukemic state of monoclonal B-cell lymphocytosis by Albert Gutierrez, Renee C. Tschumper, Xiaosheng Wu, Tait D. Shanafelt, Jeanette Eckel-Passow, Paul M. Huddleston, Susan L. Slager, Neil E. Kay, and Diane F. Jelinek Blood Volume 116(16):2975-2983 October 21, 2010 ©2010 by American Society of Hematology

Deregulation of Wnt pathway gene expression in CLL Deregulation of Wnt pathway gene expression in CLL. (A) Detection of LEF1, WNT3, TCF4 [ITF-2], and CCND2 mRNA levels by quantitative PCR in leukemic or normal B cells from 8 CLL patients and 3 healthy donor samples, respectively. Deregulation of Wnt pathway gene expression in CLL. (A) Detection of LEF1, WNT3, TCF4 [ITF-2], and CCND2 mRNA levels by quantitative PCR in leukemic or normal B cells from 8 CLL patients and 3 healthy donor samples, respectively. Transcript levels were normalized to 18s rRNA, and relative fold change was calculated using the 2−ΔΔCT method. *P < .05. Error bars represent SEM. (B) Detection of IGFBP-4 protein secretion into culture media by ELISA in B cells from 6 CLL patients and 3 healthy donor samples. The dashed line at 5 ng/mL indicates the ELISA threshold level of IGFBP-4 detection, and the horizontal lines indicate the mean of each group. Albert Gutierrez Jr et al. Blood 2010;116:2975-2983 ©2010 by American Society of Hematology

LEF-1 protein is specifically expressed by B-cell precursors and CLL cells but not mature peripheral B-cell subsets. LEF-1 protein is specifically expressed by B-cell precursors and CLL cells but not mature peripheral B-cell subsets. (A) Representative intracellular flow cytometry for LEF-1 in B cells from healthy donor bone marrow, blood, tonsil, cord blood, and CLL B cells from a CLL patient. Isotype control histogram is shaded gray; LEF-1 histogram is black. (B) Detection of LEF1 and AICDA mRNA levels by quantitative PCR in B cells from a healthy donor at 24 and 72 hours after stimulation with CpG and cytokines or anti-immunoglobulin (anti-Ig) stimulation. Fold change was calculated relative to unstimulated donor B cells; an unstimulated CLL sample served as a positive control for LEF-1 expression. (C) Detection of LEF1 mRNA levels by quantitative PCR in 2 CLL patients before and after 2 weeks in culture in AIM-V media at a density of 10 × 106 cells/mL. (D) Western blot analysis of LEF-1 isoforms in B cells from 7 CLL samples; T cells from a healthy donor and Colo 320 cells served as a control for LEF-1 isoforms. β-Actin shown as a loading control of samples. Albert Gutierrez Jr et al. Blood 2010;116:2975-2983 ©2010 by American Society of Hematology

Activation of the Wnt pathway in CLL cells and not in normal mature B cells. Activation of the Wnt pathway in CLL cells and not in normal mature B cells. (A) TCF/LEF dual luciferase reporter assay relative fold change of positive reporter samples from 6 unmutated CLL samples, 10 mutated CLL samples, and 3 normal B-cell samples. *P = .024. **P = .014. Horizontal lines indicate the mean of the group. (B) Western blot analysis of β-catenin in 6 CLL and 2 normal B-cell samples. β-Actin shown as a loading control of samples. Albert Gutierrez Jr et al. Blood 2010;116:2975-2983 ©2010 by American Society of Hematology

LEF-1 is a prosurvival factor in CLL cells. LEF-1 is a prosurvival factor in CLL cells. (A) Detection of LEF1 mRNA levels by quantitative PCR in B cells from a CLL patient 24 hours after siRNA treatment. (B) Intracellular flow cytometry measurements of LEF-1 expression with indicated change in mean fluorescence intensity (ΔMFI) 72 hours after siRNA treatment in 9 CLL samples. *P < .0001. **P < .0001. Horizontal lines indicate the mean of the group. (C) CLL percentage survival 72 hours after siRNA treatment in 9 samples (left panel), and the average fold change in survival normalized to control siRNA treatment (right panel). *P = .0001. **P = .0002. Error bars represent the SEM. Albert Gutierrez Jr et al. Blood 2010;116:2975-2983 ©2010 by American Society of Hematology

CD19+/CD5+ cells of the CLL precursor state MBL express LEF-1. CD19+/CD5+ cells of the CLL precursor state MBL express LEF-1. (A) Three representative flow cytometric analyses of peripheral blood mononuclear cells from MBL patients stained with anti-CD19, CD5, and LEF-1 antibodies. Isotype control histogram is shaded gray; LEF-1 histogram is black. Data are representative of results obtained with 8 MBL patients. (B) The change in mean fluorescence intensity (ΔMFI) between isotype and anti–LEF-1 staining in 8 MBL and 13 CLL samples. *P = .002. Horizontal lines indicate the mean of the group. Albert Gutierrez Jr et al. Blood 2010;116:2975-2983 ©2010 by American Society of Hematology