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Published in: Annals of Hematology 11/2010

01-11-2010 | Original Article

Antiapoptotic effect of interleukin-2 (IL-2) in B-CLL cells with low and high affinity IL-2 receptors

Authors: Thomas Decker, Christian Bogner, Madlen Oelsner, Christian Peschel, Ingo Ringshausen

Published in: Annals of Hematology | Issue 11/2010

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Abstract

Although B chronic lymphocytic leukemia (B-CLL) cells express the alpha chain of the interleukin-2 (IL-2) receptor CD25, little is known about the effect of IL-2 on apoptosis in B-CLL cells. We have shown previously that stimulation of B-CLL cells with a CpG-oligonucleotide induces IL-2 high affinity receptors. In our current work, we analyzed the effect of IL-2 on apoptosis in resting B-CLL cells and in our model of activated B-CLL cells (CD25 high cells). IL-2 had modest antiapoptotic activity in resting B-CLL cells. In contrast, IL-2 was much more potent to prevent apoptosis in activated cells. Prevention of cell death was also associated with the maintenance of the mitochondrial membrane potential. While only limited regulation of apoptosis controlling proteins was observed in resting B-CLL cells, IL-2 had strong effects on MCL-1, Bcl-xl, and survivin expression and inhibited Bax cleavage in CD25 high cells. Interestingly, expression of Bcl-2 was reduced. Addition of IL-2 to activated B-CLL cells caused rapid phosphorylation of Akt, while IL-2 failed to significantly phosphorylate Akt in resting B-CLL cells. Pharmacological inhibition of Akt by LY294002 restored sensitivity of activated B-CLL cells to fludarabine. IL-2 might be an important survival factor in activated B-CLL cells and might contribute to disease progression by upregulation of several critical antiapoptotic proteins.
Literature
1.
go back to reference O'Brien S, del Giglio A, Keating M (1995) Advances in the biology and treatment of B-cell chronic lymphocytic leukemia. Blood 85:307–318PubMed O'Brien S, del Giglio A, Keating M (1995) Advances in the biology and treatment of B-cell chronic lymphocytic leukemia. Blood 85:307–318PubMed
2.
go back to reference Chiorazzi N (2007) Cell proliferation and death: forgotten features of chronic lymphocytic leukemia B cells. Best Pract Res Clin Haematol 20:399–413CrossRefPubMed Chiorazzi N (2007) Cell proliferation and death: forgotten features of chronic lymphocytic leukemia B cells. Best Pract Res Clin Haematol 20:399–413CrossRefPubMed
3.
go back to reference Messmer BT, Messmer D, Allen SL, Kolitz JE, Kudalkar P, Cesar D, Murphy EJ, Koduru P, Ferrarini M, Zupo S, Cutrona G, Damle RN, Wasil T, Rai KR, Hellerstein MK, Chiorazzi N (2005) In vivo measurements document the dynamic cellular kinetics of chronic lymphocytic leukemia B cells. J Clin Invest 115:755–764PubMed Messmer BT, Messmer D, Allen SL, Kolitz JE, Kudalkar P, Cesar D, Murphy EJ, Koduru P, Ferrarini M, Zupo S, Cutrona G, Damle RN, Wasil T, Rai KR, Hellerstein MK, Chiorazzi N (2005) In vivo measurements document the dynamic cellular kinetics of chronic lymphocytic leukemia B cells. J Clin Invest 115:755–764PubMed
4.
go back to reference Ghia P, Circosta P, Scielzo C, Vallario A, Camporeale A, Granziero L, Caligaris-Cappio F (2005) Differential effects on CLL cell survival exerted by different microenvironmental elements. Curr Top Microbiol Immunol 294:135–145CrossRefPubMed Ghia P, Circosta P, Scielzo C, Vallario A, Camporeale A, Granziero L, Caligaris-Cappio F (2005) Differential effects on CLL cell survival exerted by different microenvironmental elements. Curr Top Microbiol Immunol 294:135–145CrossRefPubMed
5.
go back to reference Caligaris-Cappio F, Hamblin TJ (1999) B-cell chronic lymphocytic leukemia: a bird of a different feather. J Clin Oncol 17:399–408PubMed Caligaris-Cappio F, Hamblin TJ (1999) B-cell chronic lymphocytic leukemia: a bird of a different feather. J Clin Oncol 17:399–408PubMed
6.
go back to reference Patten PE, Buggins AG, Richards J, Wotherspoon A, Salisbury J, Mufti GJ, Hamblin TJ, Devereux S (2008) CD38 expression in chronic lymphocytic leukemia is regulated by the tumor microenvironment. Blood 111:5173–5181CrossRefPubMed Patten PE, Buggins AG, Richards J, Wotherspoon A, Salisbury J, Mufti GJ, Hamblin TJ, Devereux S (2008) CD38 expression in chronic lymphocytic leukemia is regulated by the tumor microenvironment. Blood 111:5173–5181CrossRefPubMed
7.
go back to reference Giri JG, Ahdieh M, Eisenman J, Shanebeck K, Grabstein K, Kumaki S, Namen A, Park LS, Cosman D, Anderson D (1994) Utilization of the beta and gamma chains of the IL-2 receptor by the novel cytokine IL-15. EMBO J 13:2822–2830PubMed Giri JG, Ahdieh M, Eisenman J, Shanebeck K, Grabstein K, Kumaki S, Namen A, Park LS, Cosman D, Anderson D (1994) Utilization of the beta and gamma chains of the IL-2 receptor by the novel cytokine IL-15. EMBO J 13:2822–2830PubMed
9.
go back to reference Parrish-Novak J, Dillon SR, Nelson A, Hammond A, Sprecher C, Gross JA, Johnston J, Madden K, Xu W, West J, Schrader S, Burkhead S, Heipel M, Brandt C, Kuijper JL, Kramer J, Conklin D, Presnell SR, Berry J, Shiota F, Bort S, Hambly K, Mudri S, Clegg C, Moore M, Grant FJ, Lofton-Day C, Gilbert T, Rayond F, Ching A, Yao L, Smith D, Webster P, Whitmore T, Maurer M, Kaushansky K, Holly RD, Foster D (2000) Interleukin 21 and its receptor are involved in NK cell expansion and regulation of lymphocyte function. Nature 408:57–63CrossRefPubMed Parrish-Novak J, Dillon SR, Nelson A, Hammond A, Sprecher C, Gross JA, Johnston J, Madden K, Xu W, West J, Schrader S, Burkhead S, Heipel M, Brandt C, Kuijper JL, Kramer J, Conklin D, Presnell SR, Berry J, Shiota F, Bort S, Hambly K, Mudri S, Clegg C, Moore M, Grant FJ, Lofton-Day C, Gilbert T, Rayond F, Ching A, Yao L, Smith D, Webster P, Whitmore T, Maurer M, Kaushansky K, Holly RD, Foster D (2000) Interleukin 21 and its receptor are involved in NK cell expansion and regulation of lymphocyte function. Nature 408:57–63CrossRefPubMed
10.
11.
go back to reference Lin JX, Leonard WJ (2000) The role of Stat5a and Stat5b in signaling by IL-2 family cytokines. Oncogene 19:2566–2576CrossRefPubMed Lin JX, Leonard WJ (2000) The role of Stat5a and Stat5b in signaling by IL-2 family cytokines. Oncogene 19:2566–2576CrossRefPubMed
12.
go back to reference Damle RN, Ghiotto F, Valetto A, Albesiano E, Fais F, Yan XJ, Sison CP, Allen SL, Kolitz J, Schulman P, Vinciguerra VP, Budde P, Frey J, Rai KR, Ferrarini M, Chiorazzi N (2002) B-cell chronic lymphocytic leukemia cells express a surface membrane phenotype of activated, antigen-experienced B lymphocytes. Blood 99:4087–4093CrossRefPubMed Damle RN, Ghiotto F, Valetto A, Albesiano E, Fais F, Yan XJ, Sison CP, Allen SL, Kolitz J, Schulman P, Vinciguerra VP, Budde P, Frey J, Rai KR, Ferrarini M, Chiorazzi N (2002) B-cell chronic lymphocytic leukemia cells express a surface membrane phenotype of activated, antigen-experienced B lymphocytes. Blood 99:4087–4093CrossRefPubMed
13.
go back to reference Decker T, Schneller F, Kronschnabl M, Dechow T, Lipford GB, Wagner H, Peschel C (2000) Immunostimulatory CpG-oligonucleotides induce functional high affinity IL-2 receptors on B-CLL cells: costimulation with IL-2 results in a highly immunogenic phenotype. Exp Hematol 28:558–568CrossRefPubMed Decker T, Schneller F, Kronschnabl M, Dechow T, Lipford GB, Wagner H, Peschel C (2000) Immunostimulatory CpG-oligonucleotides induce functional high affinity IL-2 receptors on B-CLL cells: costimulation with IL-2 results in a highly immunogenic phenotype. Exp Hematol 28:558–568CrossRefPubMed
14.
go back to reference Fluckiger AC, Garrone P, Durand I, Galizzi JP, Banchereau J (1993) Interleukin 10 (IL-10) upregulates functional high affinity IL-2 receptors on normal and leukemic B lymphocytes. J Exp Med 178:1473–1481CrossRefPubMed Fluckiger AC, Garrone P, Durand I, Galizzi JP, Banchereau J (1993) Interleukin 10 (IL-10) upregulates functional high affinity IL-2 receptors on normal and leukemic B lymphocytes. J Exp Med 178:1473–1481CrossRefPubMed
15.
go back to reference Tomic J, White D, Shi Y, Mena J, Hammond C, He L, Miller RL, Spaner DE (2006) Sensitization of IL-2 signaling through TLR-7 enhances B lymphoma cell immunogenicity. J Immunol 176:3830–3839PubMed Tomic J, White D, Shi Y, Mena J, Hammond C, He L, Miller RL, Spaner DE (2006) Sensitization of IL-2 signaling through TLR-7 enhances B lymphoma cell immunogenicity. J Immunol 176:3830–3839PubMed
16.
go back to reference Decker T, Schneller F, Hipp S, Miething C, Jahn T, Duyster J, Peschel C (2002) Cell cycle progression of chronic lymphocytic leukemia cells is controlled by cyclin D2, cyclin D3, cyclin-dependent kinase (cdk) 4 and the cdk inhibitor p27. Leukemia 16:327–334CrossRefPubMed Decker T, Schneller F, Hipp S, Miething C, Jahn T, Duyster J, Peschel C (2002) Cell cycle progression of chronic lymphocytic leukemia cells is controlled by cyclin D2, cyclin D3, cyclin-dependent kinase (cdk) 4 and the cdk inhibitor p27. Leukemia 16:327–334CrossRefPubMed
17.
go back to reference Tretter T, Schuler M, Schneller F, Brass U, Esswein M, Aman MJ, Huber C, Peschel C (1998) Direct cellular interaction with activated CD4(+) T cells overcomes hyporesponsiveness of B-cell chronic lymphocytic leukemia in vitro. Cell Immunol 189:41–50CrossRefPubMed Tretter T, Schuler M, Schneller F, Brass U, Esswein M, Aman MJ, Huber C, Peschel C (1998) Direct cellular interaction with activated CD4(+) T cells overcomes hyporesponsiveness of B-cell chronic lymphocytic leukemia in vitro. Cell Immunol 189:41–50CrossRefPubMed
18.
go back to reference Mellstedt H, Choudhury A (2006) T and B cells in B-chronic lymphocytic leukaemia: faust, mephistopheles and the pact with the devil. Cancer Immunol Immunother 55:210–220CrossRefPubMed Mellstedt H, Choudhury A (2006) T and B cells in B-chronic lymphocytic leukaemia: faust, mephistopheles and the pact with the devil. Cancer Immunol Immunother 55:210–220CrossRefPubMed
19.
go back to reference Jahrsdorfer B, Jox R, Muhlenhoff L, Tschoep K, Krug A, Rothenfusser S, Meinhardt G, Emmerich B, Endres S, Hartmann G (2002) Modulation of malignant B cell activation and apoptosis by bcl-2 antisense ODN and immunostimulatory CpG ODN. J Leukoc Biol 72:83–92PubMed Jahrsdorfer B, Jox R, Muhlenhoff L, Tschoep K, Krug A, Rothenfusser S, Meinhardt G, Emmerich B, Endres S, Hartmann G (2002) Modulation of malignant B cell activation and apoptosis by bcl-2 antisense ODN and immunostimulatory CpG ODN. J Leukoc Biol 72:83–92PubMed
20.
go back to reference Jahrsdorfer B, Muhlenhoff L, Blackwell SE, Wagner M, Poeck H, Hartmann E, Jox R, Giese T, Emmerich B, Endres S, Weiner GJ, Hartmann G (2005) B-cell lymphomas differ in their responsiveness to CpG oligodeoxynucleotides. Clin Cancer Res 11:1490–1499CrossRefPubMed Jahrsdorfer B, Muhlenhoff L, Blackwell SE, Wagner M, Poeck H, Hartmann E, Jox R, Giese T, Emmerich B, Endres S, Weiner GJ, Hartmann G (2005) B-cell lymphomas differ in their responsiveness to CpG oligodeoxynucleotides. Clin Cancer Res 11:1490–1499CrossRefPubMed
21.
go back to reference Longo PG, Laurenti L, Gobessi S, Petlickovski A, Pelosi M, Chiusolo P, Sica S, Leone G, Efremov DG (2007) The Akt signaling pathway determines the different proliferative capacity of chronic lymphocytic leukemia B-cells from patients with progressive and stable disease. Leukemia 21:110–120CrossRefPubMed Longo PG, Laurenti L, Gobessi S, Petlickovski A, Pelosi M, Chiusolo P, Sica S, Leone G, Efremov DG (2007) The Akt signaling pathway determines the different proliferative capacity of chronic lymphocytic leukemia B-cells from patients with progressive and stable disease. Leukemia 21:110–120CrossRefPubMed
22.
go back to reference Jones DT, Ganeshaguru K, Anderson RJ, Jackson TR, Bruckdorfer KR, Low SY, Palmqvist L, Prentice HG, Hoffbrand AV, Mehta AB, Wickremasinghe RG (2003) Albumin activates the AKT signaling pathway and protects B-chronic lymphocytic leukemia cells from chlorambucil- and radiation-induced apoptosis. Blood 101:3174–3180CrossRefPubMed Jones DT, Ganeshaguru K, Anderson RJ, Jackson TR, Bruckdorfer KR, Low SY, Palmqvist L, Prentice HG, Hoffbrand AV, Mehta AB, Wickremasinghe RG (2003) Albumin activates the AKT signaling pathway and protects B-chronic lymphocytic leukemia cells from chlorambucil- and radiation-induced apoptosis. Blood 101:3174–3180CrossRefPubMed
23.
go back to reference Lockyer HM, Tran E, Nelson BH (2007) STAT5 is essential for Akt/p70S6 kinase activity during IL-2-induced lymphocyte proliferation. J Immunol 179:5301–5308PubMed Lockyer HM, Tran E, Nelson BH (2007) STAT5 is essential for Akt/p70S6 kinase activity during IL-2-induced lymphocyte proliferation. J Immunol 179:5301–5308PubMed
24.
25.
go back to reference Ringshausen I, Schneller F, Bogner C, Hipp S, Duyster J, Peschel C, Decker T (2002) Constitutively activated phosphatidylinositol-3 kinase (PI-3K) is involved in the defect of apoptosis in B-CLL: association with protein kinase Cdelta. Blood 100:3741–3748CrossRefPubMed Ringshausen I, Schneller F, Bogner C, Hipp S, Duyster J, Peschel C, Decker T (2002) Constitutively activated phosphatidylinositol-3 kinase (PI-3K) is involved in the defect of apoptosis in B-CLL: association with protein kinase Cdelta. Blood 100:3741–3748CrossRefPubMed
26.
go back to reference Nelson BH (2004) IL-2, regulatory T cells, and tolerance. J Immunol 172:3983–3988PubMed Nelson BH (2004) IL-2, regulatory T cells, and tolerance. J Immunol 172:3983–3988PubMed
27.
go back to reference Karray S, DeFrance T, Merle-Beral H, Banchereau J, Debre P, Galanaud P (1988) Interleukin 4 counteracts the interleukin 2-induced proliferation of monoclonal B cells. J Exp Med 168:85–94CrossRefPubMed Karray S, DeFrance T, Merle-Beral H, Banchereau J, Debre P, Galanaud P (1988) Interleukin 4 counteracts the interleukin 2-induced proliferation of monoclonal B cells. J Exp Med 168:85–94CrossRefPubMed
28.
go back to reference Rezvany MR, Jeddi-Tehrani M, Wigzell H, Osterborg A, Mellstedt H (2003) Leukemia-associated monoclonal and oligoclonal TCR-BV use in patients with B-cell chronic lymphocytic leukemia. Blood 101:1063–1070CrossRefPubMed Rezvany MR, Jeddi-Tehrani M, Wigzell H, Osterborg A, Mellstedt H (2003) Leukemia-associated monoclonal and oligoclonal TCR-BV use in patients with B-cell chronic lymphocytic leukemia. Blood 101:1063–1070CrossRefPubMed
29.
go back to reference Beyer M, Kochanek M, Darabi K, Popov A, Jensen M, Endl E, Knolle PA, Thomas RK, von Bergwelt-Baildon M, Debey S, Hallek M, Schultze JL (2005) Reduced frequencies and suppressive function of CD4 + CD25hi regulatory T cells in patients with chronic lymphocytic leukemia after therapy with fludarabine. Blood 106:2018–2025CrossRefPubMed Beyer M, Kochanek M, Darabi K, Popov A, Jensen M, Endl E, Knolle PA, Thomas RK, von Bergwelt-Baildon M, Debey S, Hallek M, Schultze JL (2005) Reduced frequencies and suppressive function of CD4 + CD25hi regulatory T cells in patients with chronic lymphocytic leukemia after therapy with fludarabine. Blood 106:2018–2025CrossRefPubMed
30.
go back to reference Granziero L, Ghia P, Circosta P, Gottardi D, Strola G, Geuna M, Montagna L, Piccoli P, Chilosi M, Caligaris-Cappio F (2001) Survivin is expressed on CD40 stimulation and interfaces proliferation and apoptosis in B-cell chronic lymphocytic leukemia. Blood 97:2777–2783CrossRefPubMed Granziero L, Ghia P, Circosta P, Gottardi D, Strola G, Geuna M, Montagna L, Piccoli P, Chilosi M, Caligaris-Cappio F (2001) Survivin is expressed on CD40 stimulation and interfaces proliferation and apoptosis in B-cell chronic lymphocytic leukemia. Blood 97:2777–2783CrossRefPubMed
31.
go back to reference Ghia P, Strola G, Granziero L, Geuna M, Guida G, Sallusto F, Ruffing N, Montagna L, Piccoli P, Chilosi M, Caligaris-Cappio F (2002) Chronic lymphocytic leukemia B cells are endowed with the capacity to attract CD4+, CD40L + T cells by producing CCL22. Eur J Immunol 32:1403–1413CrossRefPubMed Ghia P, Strola G, Granziero L, Geuna M, Guida G, Sallusto F, Ruffing N, Montagna L, Piccoli P, Chilosi M, Caligaris-Cappio F (2002) Chronic lymphocytic leukemia B cells are endowed with the capacity to attract CD4+, CD40L + T cells by producing CCL22. Eur J Immunol 32:1403–1413CrossRefPubMed
32.
go back to reference Decker T, Flohr T, Trautmann P, Aman MJ, Holter W, Majdic O, Huber C, Peschel C (1995) Role of accessory cells in cytokine production by T cells in chronic B-cell lymphocytic leukemia. Blood 86:1115–1123PubMed Decker T, Flohr T, Trautmann P, Aman MJ, Holter W, Majdic O, Huber C, Peschel C (1995) Role of accessory cells in cytokine production by T cells in chronic B-cell lymphocytic leukemia. Blood 86:1115–1123PubMed
33.
go back to reference Caligaris-Cappio F, Ghia P (2008) Novel insights in chronic lymphocytic leukemia: are we getting closer to understanding the pathogenesis of the disease? J Clin Oncol 26:4497–4503CrossRefPubMed Caligaris-Cappio F, Ghia P (2008) Novel insights in chronic lymphocytic leukemia: are we getting closer to understanding the pathogenesis of the disease? J Clin Oncol 26:4497–4503CrossRefPubMed
34.
go back to reference Pepper C, Lin TT, Pratt G, Hewamana S, Brennan P, Hiller L, Hills R, Ward R, Starczynski J, Austen B, Hooper L, Stankovic T, Fegan C (2008) Mcl-1 expression has in vitro and in vivo significance in chronic lymphocytic leukemia and is associated with other poor prognostic markers. Blood 112:3807–3817CrossRefPubMed Pepper C, Lin TT, Pratt G, Hewamana S, Brennan P, Hiller L, Hills R, Ward R, Starczynski J, Austen B, Hooper L, Stankovic T, Fegan C (2008) Mcl-1 expression has in vitro and in vivo significance in chronic lymphocytic leukemia and is associated with other poor prognostic markers. Blood 112:3807–3817CrossRefPubMed
35.
go back to reference Cimmino A, Calin GA, Fabbri M, Iorio MV, Ferracin M, Shimizu M, Wojcik SE, Aqeilan RI, Zupo S, Dono M, Rassenti L, Alder H, Volinia S, Liu CG, Kipps TJ, Negrini M, Croce CM (2005) miR-15 and miR-16 induce apoptosis by targeting BCL2. Proc Natl Acad Sci U S A 102:13944–13949CrossRefPubMed Cimmino A, Calin GA, Fabbri M, Iorio MV, Ferracin M, Shimizu M, Wojcik SE, Aqeilan RI, Zupo S, Dono M, Rassenti L, Alder H, Volinia S, Liu CG, Kipps TJ, Negrini M, Croce CM (2005) miR-15 and miR-16 induce apoptosis by targeting BCL2. Proc Natl Acad Sci U S A 102:13944–13949CrossRefPubMed
36.
go back to reference Willimott S, Baou M, Naresh K, Wagner SD (2007) CD154 induces a switch in pro-survival Bcl-2 family members in chronic lymphocytic leukaemia. Br J Haematol 138:721–732CrossRefPubMed Willimott S, Baou M, Naresh K, Wagner SD (2007) CD154 induces a switch in pro-survival Bcl-2 family members in chronic lymphocytic leukaemia. Br J Haematol 138:721–732CrossRefPubMed
37.
go back to reference Zinkel S, Gross A, Yang E (2006) BCL2 family in DNA damage and cell cycle control. Cell Death Differ 13:1351–1359CrossRefPubMed Zinkel S, Gross A, Yang E (2006) BCL2 family in DNA damage and cell cycle control. Cell Death Differ 13:1351–1359CrossRefPubMed
38.
go back to reference Smit LA, Hallaert DY, Spijker R, de Goeij B, Jaspers A, Kater AP, van Oers MH, van Noesel CJ, Eldering E (2007) Differential Noxa/Mcl-1 balance in peripheral versus lymph node chronic lymphocytic leukemia cells correlates with survival capacity. Blood 109:1660–1668CrossRefPubMed Smit LA, Hallaert DY, Spijker R, de Goeij B, Jaspers A, Kater AP, van Oers MH, van Noesel CJ, Eldering E (2007) Differential Noxa/Mcl-1 balance in peripheral versus lymph node chronic lymphocytic leukemia cells correlates with survival capacity. Blood 109:1660–1668CrossRefPubMed
39.
go back to reference Hallaert DY, Jaspers A, van Noesel CJ, van Oers MH, Kater AP, Eldering E (2008) c-Abl kinase inhibitors overcome CD40-mediated drug resistance in CLL: implications for therapeutic targeting of chemoresistant niches. Blood 112:5141–5149CrossRefPubMed Hallaert DY, Jaspers A, van Noesel CJ, van Oers MH, Kater AP, Eldering E (2008) c-Abl kinase inhibitors overcome CD40-mediated drug resistance in CLL: implications for therapeutic targeting of chemoresistant niches. Blood 112:5141–5149CrossRefPubMed
40.
go back to reference Deaglio S, Malavasi F (2009) Chronic lymphocytic leukemia microenvironment: shifting the balance from apoptosis to proliferation. Haematologica 94:752–756CrossRefPubMed Deaglio S, Malavasi F (2009) Chronic lymphocytic leukemia microenvironment: shifting the balance from apoptosis to proliferation. Haematologica 94:752–756CrossRefPubMed
41.
go back to reference Engelman JA (2009) Targeting PI3K signalling in cancer: opportunities, challenges and limitations. Nat Rev Cancer 9:550–562CrossRefPubMed Engelman JA (2009) Targeting PI3K signalling in cancer: opportunities, challenges and limitations. Nat Rev Cancer 9:550–562CrossRefPubMed
Metadata
Title
Antiapoptotic effect of interleukin-2 (IL-2) in B-CLL cells with low and high affinity IL-2 receptors
Authors
Thomas Decker
Christian Bogner
Madlen Oelsner
Christian Peschel
Ingo Ringshausen
Publication date
01-11-2010
Publisher
Springer-Verlag
Published in
Annals of Hematology / Issue 11/2010
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-010-0994-1

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