Treatment for higher-risk patients with
myelodysplastic syndrome (MDS) should aim to modify the disease course by avoiding progression to
acute myeloid leukemia and improving survival. When a patient is not eligible for intensive
chemotherapy and lacks a donor hematopoietic cell source, or for a patient in a poor economic situation, consideration can be given to the use of Chinese herbal medicine. Numerous
plant extracts, such as
camptothecin,
vinblastine and
paclitaxel, have been reported to display antitumor effects, serving as potential therapeutic strategies for
cancer. In the present study, the ultra-performance liquid chromatography-tandem mass spectrometry system (Waters Corporation) was used to detect the main chemical components of HDE,
CCK-8 assay to detect the effects of HDE and
BIIB021 on the proliferation of SKM-1 cells; and designed hTERT-small interfering (si)RNAs to detect the effects of HDE and
BIIB021 on SKM-1 cell apoptosis after HTERT gene knockdown. The present study investigated a newly extracted
coumarin HDE, the active component in Oldenlandia diffusa Willd, which efficiently inhibited SKM-1 (MDS cell line) proliferation and induced apoptosis, as determined by performing Cell Counting Kit-8 and flow cytometry assays, respectively. The effect of HDE was associated with decreased
telomerase activity. Moreover,
heat shock protein 90 inhibitor
BIIB021 significantly enhanced the antitumor effects of HDE on SKM-1 cells. In addition, SKM-1 cell apoptosis was increased in human
telomerase reverse transcriptase (hTERT)-knockdown cells compared with the negative control group. Cell apoptosis in hTERT-knockdown SKM-1 cells was further enhanced following HDE,
BIIB021 or combination treatment, as evidenced by increased levels of cleaved
caspase 3, cleaved
caspase 8 and cleaved
poly ADP ribose polymerase. Collectively, the results indicated synergistic antitumor effects of HDE and
BIIB021, providing a novel therapeutic combination for higher-risk MDS.