Receptor tyrosine kinase-like orphan receptor 1 (ROR1) is an oncoembryonic antigen found on chronic lymphocytic leukemia (CLL) B cells, but not on normal adult tissues. We generated transgenic (Tg) mice with human ROR1 regulated by the murine Ig promoter/enhancer. In contrast to nontransgenic littermates, such animals had B-cell-restricted expression of ROR1 and could develop clonal expansions of ROR1 bright CD5 + B220 low B cells resembling human CLL at ≥15 mo of age. Because immune-precipitation and mass spectrometry studies revealed that ROR1 could complex with T-cell leukemia 1 (TCL1) in CLL, we crossed these animals with Eμ-TCL1-Tg (TCL1) mice. Progeny with both transgenes (ROR1 × TCL1) developed CD5 +
B220low B-cell lymphocytosis and leukemia at a significantly younger median age than did littermates with either transgene alone. ROR1 × TCL1 leukemia B cells had higher levels of phospho-AKT than TCL1 leukemia cells and expressed high levels of human ROR1, which we also found complexed with TCL1. Transcriptome analyses revealed that ROR1 × TCL1 leukemia cells had higher expression of subnetworks implicated in embryonic and tumor-cell proliferation, but lower expression of subnetworks involved in cell-cell adhesion or cell death than did TCL1 leukemia cells. ROR1 × TCL1 leukemia cells also had higher proportions of K i -67-positive cells, lower proportions of cells undergoing spontaneous apoptosis, and produced more aggressive disease upon adoptive transfer than TCL1 leukemia cells. However, treatment with an anti-ROR1 mAb resulted in ROR1 down-modulation, reduced phospho-AKT, and impaired engraftment of ROR1 × TCL1 leukemia cells. Our data demonstrate that ROR1 accelerates development/progression of leukemia and may be targeted for therapy of patients with CLL. mouse model | monoclonal antibody | AKT | immune therapy R eceptor tyrosine kinase-like orphan receptor 1 (ROR1) is a type 1 tyrosine kinase surface protein expressed on chronic lymphocytic leukemia (CLL) B cells, but not on nonmalignant postpartum tissues (1). Expression of ROR1 ordinarily is confined to early embryogenesis, where it contributes to organogenesis (2-4). However, ROR1 is not detected on postpartum tissues, including hematopoietic stem cells, except on a small subset of B-cell precursors, called hematogones (5). We and others have found ROR1 expressed on the neoplastic cells of patients with CLL (1, 6, 7), other B-cell lymphomas (8), acute leukemias (5, 9), and on any one of a variety of solid tumors (10-13). However, it still is uncertain whether ROR1 plays a role in cancer development and/or disease progression.ROR1 has an extracellular domain that is essential for ligand binding and potentially for intracellular signaling (14). Although it has a putative kinase domain, ROR1 might function as a pseudokinase, serving instead as a cofactor for other signaling proteins (13). We found that ROR1 could serve as a receptor for Wnt5a, which could provide a survival/growth signal to CLL cells from the microenvironment (1). Also, ROR1 could enh...