We sought to define the cellular activity that mediates resistance in human leukemic cells (CCRF-CEM) to the nucleoside 9-β-d-arabinofuranosyladenine (ara-A). Stable mutants were obtained by continuous selection at ara-A concentrations of 1 or 2.5 µm in the presence of the adenosine deaminase inhibitor 2′-deoxycoformycin. Four clones selected for further investigation were 4- to 11-fold less sensitive to the cytotoxicity of ara-A than the parental CCRF-CEM line. These clones also showed cross-resistance to deoxyadenosine and thymidine, but normal sensitivity to arabinosylcytosine and adenosine, and increased sensitivity to the etoposide VP16-213. No change was found in the activity of kinases that phosphorylate ara-A and the various nucleosides that could account for the resistant phenotype in these mutant lines. Resistance was associated with a 2- to 8-fold increase in the level of all four deoxyribonucleoside triphosphates. The triphosphate pools in the mutants were resistant to the inhibition produced in wild-type cells by addition of deoxyadenosine or thymidine, although significant activation in the deoxyguanosine triphosphate pool was obtained by higher concentrations of thymidine. An examination of ribonucleotide reductase in extracts of two of the mutants revealed a specific alteration in the normal sensitivity of the enzyme for deoxyadenosine triphosphate and adenosine triphosphate but not 9-β-d-Arabinofuranosyladenine 5′-triphosphate. When the level of ribonucleotide reductase activity was measured, it was found that the ara-A-resistant cells contained approximately twice the wild-type level of cytidine diphosphate reductase activity at physiological adenosine triphosphate level. This combination of increased enzyme activity and alteration in sensitivity to the nucleoside triphosphates could account for both the changes in deoxyribonucleotide pool sizes and the resistant phenotype of the presumed mutants.

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Supported by NIH Research Grant CA 33017, National Cancer Institute Cancer Center Core Grant CA 21765, and American Lebanese Syrian Associated Charities.

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