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Fat cells appear to block anti-cancer drugs

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SUNCOAST NEWS STAFF REPORT

The Tampa Tribune

Published: November 26, 2009

Doctors know that obesity can render children less likely to benefit from anti-cancer drug therapy and suffer relapse. Researchers think they may know why.

Because leukemia is the most common from of cancer among children, researchers in California used mice to create laboratory models of obesity and leukemia.

What they discovered, and reported first in the online version of the journal Cancer Research is that leukemia cells can find a "safe haven" among fat cells, known as adipocytes, and ride out the storm of anti-cancer drugs doctors used to kill them. This could leave them free to flourish again once chemotherapy ends.

The research team, led by Dr. Steven D. Mittelman, fellowship research director with the Division of Endocrinology at Childrens Hospital Los Angeles, cultured fat and leukemia cells together, and treated the leukemia cells with traditional chemotherapy drugs used in children - vincristine, nilotinib, daunorubicin and dexamethasone.

What they discovered was that the chemotherapy treatments all worked less effectively in culture when fat cells were present.

When the mice in the study relapsed from the leukemia, the researchers found leukemia "hiding out" in the fat tissue during chemotherapy, according to Mittelman, assistant professor of pediatrics, physiology and biophysics at the Keck School of Medicine, University of Southern California.

"These four drugs attack leukemia cells by different routes, so when we saw fat cells blocking them we realized there could be an important mechanism promoting their ability to live and divide," he said. "We were surprised to find leukemia cells in the fat tissue."

Dr. David Hockenbery, a member of the Fred Hutchinson Cancer Research Center and professor of internal medicine at the University of Washington, said "this study provides striking experimental support for the clinical observations that obesity is associated with poor prognosis in multiple cancers."

More research is now needed to figure out how fat cells become part of the tumor microenvironment and how they block potentially lifesaving treatments, according to Mittelman.

He and his colleagues are conducting additional studies to evaluate other chemotherapeutics, how obesity may or may not affect treatment and the effect of fat cells found in bone marrow on leukemia.

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