The microtubule-dependent motor protein Eg5 plays a critical role in spindle assembly and maintenance in mitosis. Herein we show that the suppression of Eg5 by a specific inhibitor arrested mitosis, induced apoptosis, and up-regulated Hsp70 in human multiple myeloma cells. Mechanistically, Hsp70 induction occurred at the transcriptional level via a cis-regulatory DNA element in Hsp70 promoter and was mediated by the phosphatidylinositol 3-kinase/ Akt pathway. Eg5 inhibitor-mediated Hsp70 up-regulation is cytoprotective because blocking Hsp70 induction directly by antisense or small interfering RNA or indirectly by inhibiting the phosphatidylinositol 3-kinase/Akt pathway significantly increased Eg5 inhibitor-induced apoptosis. Furthermore, a farnesyltransferase inhibitor interacted synergistically with the Eg5 inhibitor in inducing apoptosis through disrupting the Akt/Hsp70 signaling axis. These findings provide the first evidence for Eg5 inhibitor activity in hematologic malignancy and identify Hsp70 up-regulation as a critical mechanism responsible for modulating myeloma cell sensitivity to Eg5 inhibitors. In addition, these findings suggest that a combination of Eg5 inhibitors with agents abrogating Hsp70 induction would be useful for myeloma therapy in the clinic.The mitotic spindle, composed of microtubules and their associated proteins, is the major machinery that orchestrates chromosome segregation during mitosis (1). Chemical agents that interfere with the mitotic spindle, such as taxanes and vinca alkaloids, have proven effective clinically in the treatment of human malignancies (2-4). These chemotherapeutic agents target tubulin and alter microtubule dynamics. As a result, they impair the assembly and function of the mitotic spindle and cause cell cycle arrest in mitosis, ultimately leading to apoptosis (3, 4). However, because microtubules are involved in many other cellular processes such as cell shaping, cell motility, and intracellular transport, use of microtubule inhibitors in cancer therapy is often associated with mechanism-based toxicities to normal tissues, notably neurotoxicity (4 -6). Consequently, it is necessary to search for agents that target spindle components other than tubulin and display reduced side effects and better pharmacological profiles.Inhibitors of Eg5 (also named kinesin spindle protein or kinesin-5) have emerged as a new class of agents that interfere with the mitotic spindle (7). Eg5 is a microtubule-dependent motor protein of the kinesin family that is crucial in mitosis for spindle assembly and maintenance (8 -16). The first small-molecule inhibitor of Eg5, monastrol, was discovered in a phenotype-based screening and so named because it gave rise to cells with monopolar spindles (monoasters) (10). Since then, a number of Eg5 inhibitors have been identified, including HR22C16, CK0106023, EG5-IA, and dimethylenastron (17)(18)(19)(20). Dimethylenastron is a member of the quinazoline-2(1H)-thione class and is identified in an in vitro ATPase assay-based screening as a speci...