Leukemia relapse and nonrecurrence mortality (NRM) due to
leukemia stem cells (LSCs) represent major problems following
hematopoietic stem cell transplantation (HSCT). To eliminate LSCs, the sensitivity of LSCs to chemotherapeutic agents used in conditioning regimens should be enhanced.
Curcumin (CUR) has received considerable attention as a result of its anticancer activity in
leukemia and solid
tumors. In this study, we investigated the cytotoxic effects and underlying mechanisms in
leukemia stem-like KG1a cells exposed to
busulfan (BUS) and CUR, either alone or in combination. KG1a cells exhibiting BUS-resistance demonstrated by MTT and
annexin V/
propidium iodide (PI) assays, compared with HL-60 cells. CUR induced cell growth inhibition and apoptosis in KG1a cells. Apoptosis of KG1a cells was significantly enhanced by treatment with CUR+BUS, compared with either agent alone. CUR synergistically enhanced the cytotoxic effect of BUS. Seven apoptosis-related
proteins were modulated in CUR- and CUR+BUS-treated cells analyzed by
proteins array analysis. Importantly, the antiapoptosis
protein survivin was significantly downregulated, especially in combination group. Suppression of
survivin with specific inhibitor
YM155 significantly increased the susceptibility of KG1a cells to BUS. These results demonstrated that CUR could increase the sensitivity of
leukemia stem-like KG1a cells to BUS by downregulating the expression of
survivin.