Epigenetics of acute lymphocytic leukemia

Epigenetic changes to human umbilical cord blood cells cultured with three proteins indicate partial reprogramming to a pluripotent state

We have previously reported the existence of a subpopulation of cells from human umbilical cord blood capable of differentiating into oligodendrocytes, Schwann cells, bone, muscle, and endothelial cells despite their origins as CD45-positive cells. These stem cells (called FSFl cells) arise only after a period in vitro in medium containing FGF4, SCF, and Flt-3 ligand (FSFl medium) during which they express the pluripotency genes Oct4 and Nanog. The objective of this study was to determine if the novel expression of these pluripotency genes coupled with the newly acquired ability of these cells to differentiate into all three germ layers was the result of epigenetic changes to these cells after reprogramming in FSFl medium. We confirm that CD45-derived FSFl cells express Oct4 protein at levels similar to that observed among undifferentiated embryonic stem cells, during which time acetylated histones H3 and H4 display increased binding at the promoter region of Oct4. Changes to binding of acetylated histones at Oct4 when these cells are in a differentiated state (either prior to FSFl culture or after in vitro differentiation into neural cells) and when they are undifferentiated suggest that this is one way by which these cells acquire their pluripotency. While DNA hypermethylation at this gene region as well as the continued H3 and H4 acetylation at the CD45 promoter region among FSFl cells indicate this is only a partial reprogramming event, this is a significant step toward non-transgene reprogramming of somatic cells.

Decitabine

The pyrimidine analogs, 5-azacytidine (azacitidine, Vidaza) and its deoxy derivative, 5-aza-2'-deoxycytidine (decitabine, Dacogen, are the most widely used inhibitors of DNA methylation which trigger demethylation leading to a consecutive reactivation of epigenetically silenced tumor suppressor genes in vitro and in vivo. Although the antileukemic capacity of decitabine has been known for almost 40 years, its therapeutic potential in hematologic malignancies is still under intensive investigation. Multiple clinical trials have shown the promising activity of low-dose decitabine in AML, MDS, CML, and hemoglobinopathies, whereas its efficacy in solid tumors is rather limited.Clinical responses appear to be induced by both epigenetic alterations and the induction of cell-cycle arrest and/or apoptosis. Recent clinical trials have been investigating new dosing schedules, routes of administration, and combination of decitabine with other agents, including histone deacetylase (HDAC) inhibitors.

Leukaemogenesis: more than mutant genes

Acute leukaemias are characterized by recurring chromosomal aberrations and gene mutations that are crucial to disease pathogenesis. It is now evident that epigenetic modifications, including DNA methylation and histone modifications, substantially contribute to the phenotype of leukaemia cells. An additional layer of epigenetic complexity is the pathogenetic role of microRNAs in leukaemias, and their key role in the transcriptional regulation of tumour suppressor genes and oncogenes. The genetic heterogeneity of acute leukaemias poses therapeutic challenges, but pharmacological agents that target components of the epigenetic machinery are promising as a component of the therapeutic arsenal for this group of diseases.

Cytogenetics and molecular genetics of acute lymphoblastic leukemia

Acute lymphoblastic leukemia (ALL) is a malignant disease that often features nonrandom numerical or structural chromosome aberrations that can be detected microscopically. The application of contemporary genome-wide molecular analyses is revealing additional genetic alterations that are not detectable cytogenetically. This article describes the cytogenetic methodology and summarizes major cytogenetic findings and their clinical relevance in ALL. The article provides a review of modern molecular techniques and their application in the research on the genetics and epigenetics of ALL.