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Sahasrabudhe DM, Liesveld JL, Minhajuddin M, Singh NA, Nath S, Kumar VM, Balys M, Evans AG, Azadniv M, Hansen JN, Becker MW, Sharon A, Thomas VK, Moore RG, Khera MK, Jordan CT, Singh RK. In silico predicted compound targeting the IQGAP1-GRD domain selectively inhibits growth of human acute myeloid leukemia. Sci Rep 2024; 14:12868. [PMID: 38834690 PMCID: PMC11150481 DOI: 10.1038/s41598-024-63392-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 05/28/2024] [Indexed: 06/06/2024] Open
Abstract
Acute myeloid leukemia (AML) is fatal in the majority of adults. Identification of new therapeutic targets and their pharmacologic modulators are needed to improve outcomes. Previous studies had shown that immunization of rabbits with normal peripheral WBCs that had been incubated with fluorodinitrobenzene elicited high titer antibodies that bound to a spectrum of human leukemias. We report that proteomic analyses of immunoaffinity-purified lysates of primary AML cells showed enrichment of scaffolding protein IQGAP1. Immunohistochemistry and gene-expression analyses confirmed IQGAP1 mRNA overexpression in various cytogenetic subtypes of primary human AML compared to normal hematopoietic cells. shRNA knockdown of IQGAP1 blocked proliferation and clonogenicity of human leukemia cell-lines. To develop small molecules targeting IQGAP1 we performed in-silico screening of 212,966 compounds, selected 4 hits targeting the IQGAP1-GRD domain, and conducted SAR of the 'fittest hit' to identify UR778Br, a prototypical agent targeting IQGAP1. UR778Br inhibited proliferation, induced apoptosis, resulted in G2/M arrest, and inhibited colony formation by leukemia cell-lines and primary-AML while sparing normal marrow cells. UR778Br exhibited favorable ADME/T profiles and drug-likeness to treat AML. In summary, AML shows response to IQGAP1 inhibition, and UR778Br, identified through in-silico studies, selectively targeted AML cells while sparing normal marrow.
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Affiliation(s)
- Deepak M Sahasrabudhe
- Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY, 14618, USA.
- Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA.
| | - Jane L Liesveld
- Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, Box 704, Rochester, NY, 14618, USA
- Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Mohammad Minhajuddin
- Division of Hematology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, US
| | - Niloy A Singh
- Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Subhangi Nath
- Department of Chemistry, Birla Institute of Technology, Ranchi, Jharkhand, India
| | - Vishuwes Muthu Kumar
- Department of Chemistry, Birla Institute of Technology, Ranchi, Jharkhand, India
| | - Marlene Balys
- Genomics Research Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Andrew G Evans
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Mitra Azadniv
- Department of Medicine, Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA
| | - Jeanne N Hansen
- Department of Psychological and Brain Sciences, Colgate University, Hamilton, NY, USA
| | | | - Ashoke Sharon
- Department of Chemistry, Birla Institute of Technology, Ranchi, Jharkhand, India
| | - V Kaye Thomas
- Department of Pharmacology and Physiology, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Richard G Moore
- Division of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA
| | - Manoj K Khera
- Presude Lifesciences Pvt Ltd., Uttam Nagar, New Delhi, 110059, India
| | - Craig T Jordan
- Division of Hematology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, US
| | - Rakesh K Singh
- Division of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA.
- Wilmot Cancer Institute, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
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Huang YM, Wang YN, Zheng Y, Pan LL, Li Y, Li JG, Wang SY. The prognostic value of the peripheral blood cell counts changes during induction chemotherapy in Chinese patients with adult acute myeloid leukemia. Medicine (Baltimore) 2021; 100:e24614. [PMID: 33663070 PMCID: PMC7909157 DOI: 10.1097/md.0000000000024614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 01/07/2021] [Indexed: 01/05/2023] Open
Abstract
To investigate the prognostic value of the circulating peripheral blood cell counts changes in acute myeloid leukemia (AML) at different time points during induction chemotherapy.We retrospectively analyzed the clinical and laboratory data of 237 newly diagnosed AML patients admitted to Fujian Medical University Union Hospital from January 2011 to December 2014.1. When primitive cells were first removed from the circulating peripheral blood, it was called peripheral blood blast clearance (PBBC). These patients were divided into two groups, according to PBBC. Statistical analysis showed that the day 5 of induction chemotherapy was a better cut-off for PBBC. PBBC≤5 days is defined as early-blast-clearance, while PBBC >6 days is delayed-blast-clearance. There was significant difference between the two groups on complete remission (CR) rate (P = .002), recurrence-free survival (RFS) (P = .026) and overall survival (OS) (P = .001). 2. Multivariate analysis suggested PBBC is an independent prognostic factor for CR, RFS, and OS in AML. Receiver operating characteristic(ROC) curve analysis showed the CR rate of patients with white blood cell count less than 1.25 × 109/L was significantly higher than that of patients with white blood cell count more than 1.25 × 10 9/L (P < .001) at day 5 of induction chemotherapy, but the RFS and OS was no significantly different (P > .05).The dynamics of peripheral blood blast in AML after initiation of induction chemotherapy, especially the time length to achieve PBBC, has important prognostic value for CR rate, RFS, and OS in AML patients. It is a simple and feasible method to evaluate the efficacy of AML.
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Affiliation(s)
- Yuan-Mao Huang
- Union Clinical Medical College, Fujian Medical University
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou
- Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, Fujian, P.R. China
| | - Yan-Ni Wang
- Union Clinical Medical College, Fujian Medical University
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou
| | - Yi Zheng
- Union Clinical Medical College, Fujian Medical University
| | - Li-Li Pan
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou
| | - Yang Li
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou
| | - Jing-Gang Li
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou
| | - Shao-Yuan Wang
- Union Clinical Medical College, Fujian Medical University
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou
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Knorr KLB, Goldberg AD. Leukemia stem cell gene expression signatures contribute to acute myeloid leukemia risk stratification. Haematologica 2020; 105:533-536. [PMID: 32115413 DOI: 10.3324/haematol.2019.241117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Katherine L B Knorr
- Division of Hematologic Malignancies, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Aaron D Goldberg
- Division of Hematologic Malignancies, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Ciftciler R, Demiroglu H, Haznedaroglu IC, Sayınalp N, Aksu S, Ozcebe O, Goker H, Aydın MS, Buyukasık Y. Impact of Time Between Induction Chemotherapy and Complete Remission on Survival Outcomes in Patients With Acute Myeloid Leukemia. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2019; 19:729-734. [PMID: 31540855 DOI: 10.1016/j.clml.2019.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/09/2019] [Accepted: 08/16/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND The majority of patients with acute myeloid leukemia (AML) receive intensive induction chemotherapy for obtaining a complete remission (CR). Despite consolidation chemotherapy and advances in allogeneic hematopoietic stem cell transplantation, most of these patients finally relapse and die from AML. The aim of this study is to determine the impact of duration of remission achievement on survival of patients with newly diagnosed AML who achieve CR after induction chemotherapy. MATERIALS AND METHODS We retrospectively analyzed patients with AML who received first induction chemotherapy between 2001 and 2018. RESULTS The 5-year overall survival for patients who had early remission after induction chemotherapy and patients who had delayed remission after induction chemotherapy were 83% (95% confidence interval [CI], 0.79-0.87) and 35% (95% CI, 0.31-0.39), respectively (P < .001). The 5-year disease-free survival for patients who had early remission after induction chemotherapy and patients who had delayed remission after induction chemotherapy were 81% (95% CI, 0.75-0.87) and 28% (95% CI, 0.21-0.35), respectively (P < .001). CONCLUSION In conclusion, time to entering CR is a predictor factor of overall survival and disease-free survival for patients with newly diagnosed AML who achieve CR after first induction chemotherapy. Patients achieving CR only after a lengthy time (eg, more than 29 days) should be considered to have high relapse rate and should undergo allogeneic hematopoietic stem cell transplantation.
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Affiliation(s)
- Rafiye Ciftciler
- Department of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Haluk Demiroglu
- Department of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Nilgun Sayınalp
- Department of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Salih Aksu
- Department of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Osman Ozcebe
- Department of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hakan Goker
- Department of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Muruvvet Seda Aydın
- Department of Hematology, Ankara Numune Eduacation and Research Hospital, Ankara, Turkey
| | - Yahya Buyukasık
- Department of Hematology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Epigenetic Abnormalities in Acute Myeloid Leukemia and Leukemia Stem Cells. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019. [PMID: 31338820 DOI: 10.1007/978-981-13-7342-8_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2023]
Abstract
Recently advances in cancer genomics revealed the unexpected high frequencies of epigenetic abnormalities in human acute myeloid leukemia (AML). Accumulating data suggest that these leukemia-associated epigenetic factors play critical roles in both normal hematopoietic stem cells (HSCs) and leukemia stem cells (LSCs). In turn, these abnormalities result in susceptibilities of LSC and related diseases to epigenetic inhibitors. In this chapter, we will focus on the mutations of epigenetic factors in AML, their functional roles and mechanisms in normal hematopoiesis and leukemia genesis, especially in LSC, and potential treatment opportunities specifically for AML with epigenetic dysregulations.
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Knorr KL, Finn LE, Smith BD, Hess AD, Foran JM, Karp JE, Kaufmann SH. Assessment of Drug Sensitivity in Hematopoietic Stem and Progenitor Cells from Acute Myelogenous Leukemia and Myelodysplastic Syndrome Ex Vivo. Stem Cells Transl Med 2017; 6:840-850. [PMID: 28297583 PMCID: PMC5442784 DOI: 10.5966/sctm.2016-0034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 09/19/2016] [Indexed: 01/24/2023] Open
Abstract
Current understanding suggests that malignant stem and progenitor cells must be reduced or eliminated for prolonged remissions in myeloid neoplasms such as acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS). Multicolor flow cytometry has been widely used to distinguish stem and myeloid progenitor cells from other populations in normal and malignant bone marrow. In this study, we present a method for assessing drug sensitivity in MDS and AML patient hematopoietic stem and myeloid progenitor cell populations ex vivo using the investigational Nedd8‐activating enzyme inhibitor MLN4924 and standard‐of‐care agent cytarabine as examples. Utilizing a multicolor flow cytometry antibody panel for identification of hematopoietic stem cells, multipotent progenitors, common myeloid progenitors, granulocyte‐monocyte progenitors, and megakaryocyte‐erythroid progenitors present in mononuclear cell fractions isolated from bone marrow aspirates, we compare stem and progenitor cell counts after treatment for 24 hours with drug versus diluent. We demonstrate that MLN4924 exerts a cytotoxic effect on MDS and AML stem and progenitor cell populations, whereas cytarabine has more limited effects. Further application of this method for evaluating drug effects on these populations ex vivo and in vivo may inform rational design and selection of therapies in the clinical setting. Stem Cells Translational Medicine2017;6:840–850
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Affiliation(s)
- Katherine L.B. Knorr
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
| | - Laura E. Finn
- Division of Hematology and Oncology, Mayo Clinic, Jacksonville, Florida, USA
| | - B. Douglas Smith
- Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Allan D. Hess
- Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - James M. Foran
- Division of Hematology and Oncology, Mayo Clinic, Jacksonville, Florida, USA
| | - Judith E. Karp
- Division of Oncology Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Scott H. Kaufmann
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
- Division of Hematological Malignancies, Sidney Kimmel Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA
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Short NJ, Benton CB, Chen H, Qiu P, Gu L, Pierce S, Brandt M, Maiti A, Min TL, Naqvi K, Quintas‐Cardama A, Konopleva M, Kadia T, Cortes J, Garcia‐Manero G, Ravandi F, Jabbour E, Kantarjian H, Andreeff M. Peripheral blood blast clearance is an independent prognostic factor for survival and response to acute myeloid leukemia induction chemotherapy. Am J Hematol 2016; 91:1221-1226. [PMID: 27474808 DOI: 10.1002/ajh.24500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 07/19/2016] [Accepted: 07/28/2016] [Indexed: 01/17/2023]
Abstract
In patients with acute myeloid leukemia (AML), rapid reduction of circulating blasts with induction chemotherapy may serve as an in vivo marker of chemosensitivity. We performed a retrospective analysis of 363 patients with untreated AML who received induction chemotherapy in order to determine the relationship between day of blast disappearance (DOBD) and complete remission (CR) rates, event-free survival (EFS), and overall survival (OS). DOBD ≤ 5 vs. >5 was identified as the most discriminating cutoff for OS. DOBD > 5 was observed in 35 patients (9.6%). The CR rate for patients with DOBD ≤ 5 vs. >5 was 74.0 and 28.6%, median EFS was 9.4 and 1.8 months, and median OS was 17.1 and 5.8 months, respectively (P < 0.001 for all). DOBD > 5 was independently associated with a lower CR rate and shorter EFS and OS (P < 0.001 for all). DOBD > 5 retained prognostic significance for EFS and OS when patients were stratified by cytogenetic risk group, de novo vs. secondary or therapy-related AML, European LeukemiaNet-based risk groups, and whether CR was achieved. We propose DOBD > 5 as a simple and early marker of disease resistance that identifies patients with poor prognosis who otherwise may not be identified with existing risk stratification systems. Am. J. Hematol. 91:1221-1226, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Nicholas J. Short
- Division of Cancer MedicineThe University of Texas MD Anderson Cancer CenterHouston Texas
| | - Christopher B. Benton
- Department of LeukemiaThe University of Texas MD Anderson Cancer CenterHouston Texas
| | - Hsiang‐Chun Chen
- Department of BiostatisticsThe University of Texas MD Anderson Cancer CenterHouston Texas
| | - Peng Qiu
- Department of Biomedical EngineeringGeorgia Institute of TechnologyAtlanta Georgia
| | - Lisa Gu
- Baylor College of MedicineHouston Texas
| | - Sherry Pierce
- Department of LeukemiaThe University of Texas MD Anderson Cancer CenterHouston Texas
| | - Mark Brandt
- Department of LeukemiaThe University of Texas MD Anderson Cancer CenterHouston Texas
| | - Abhishek Maiti
- Department of Internal MedicineThe University of Texas Health Science CenterHouston Texas
| | | | - Kiran Naqvi
- Department of LeukemiaThe University of Texas MD Anderson Cancer CenterHouston Texas
| | | | - Marina Konopleva
- Department of LeukemiaThe University of Texas MD Anderson Cancer CenterHouston Texas
| | - Tapan Kadia
- Department of LeukemiaThe University of Texas MD Anderson Cancer CenterHouston Texas
| | - Jorge Cortes
- Department of LeukemiaThe University of Texas MD Anderson Cancer CenterHouston Texas
| | | | - Farhad Ravandi
- Department of LeukemiaThe University of Texas MD Anderson Cancer CenterHouston Texas
| | - Elias Jabbour
- Department of LeukemiaThe University of Texas MD Anderson Cancer CenterHouston Texas
| | - Hagop Kantarjian
- Department of LeukemiaThe University of Texas MD Anderson Cancer CenterHouston Texas
| | - Michael Andreeff
- Department of LeukemiaThe University of Texas MD Anderson Cancer CenterHouston Texas
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He SJ, Shu LP, Zhou ZW, Yang T, Duan W, Zhang X, He ZX, Zhou SF. Inhibition of Aurora kinases induces apoptosis and autophagy via AURKB/p70S6K/RPL15 axis in human leukemia cells. Cancer Lett 2016; 382:215-230. [PMID: 27612557 DOI: 10.1016/j.canlet.2016.08.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/28/2016] [Accepted: 08/17/2016] [Indexed: 01/19/2023]
Abstract
Leukemia is a common malignancy of blood cells with poor prognosis in many patients. Aurora kinases, a family of serine/threonine kinases, play a key role in regulating cell division and mitosis and are linked to tumorigenesis, metastasis, and poor prognosis in many human cancers including leukemia and lymphoma. Danusertib (Danu) is a pan-inhibitor of Aurora kinases with few data available in leukemia therapy. This study aimed to identify new molecular targets for Aurora kinase inhibition in human leukemia cells using quantitative proteomic analysis followed by verification experiments. There were at least 2932 proteins responding to Danu treatment, including AURKB, p70S6K, and RPL15, and 603 functional proteins and 245 canonical signaling pathways were involved in regulating cell proliferation, metabolism, apoptosis, and autophagy. The proteomic data suggested that Danu-regulated RPL15 signaling might contribute to the cancer cell killing effect. Our verification experiments confirmed that Danu negatively regulated AURKB/p70S6K/RPL15 axis with the involvement of PI3K/Akt/mTOR, AMPK, and p38 MAPK signaling pathways, leading to the induction of apoptosis and autophagy in human leukemia cells. Further studies are warranted to verify the feasibility via targeting AURKB/p70S6K/RPL15 axis for leukemia therapy.
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Affiliation(s)
- Si-Jia He
- Department of Pediatrics, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China; Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Center & Sino-US Joint Laboratory for Medical Sciences, Laboratory Animal Center, Guiyang Medical University, Guiyang 550004, China; Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL 33612, USA
| | - Li-Ping Shu
- Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Center & Sino-US Joint Laboratory for Medical Sciences, Laboratory Animal Center, Guiyang Medical University, Guiyang 550004, China
| | - Zhi-Wei Zhou
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL 33612, USA
| | - Tianxin Yang
- Department of Internal Medicine, University of Utah and Salt Lake Veterans Affairs Medical Center, Salt Lake City, Utah, USA
| | - Wei Duan
- School of Medicine, Deakin University, Waurn Ponds, Victoria 3217, Australia
| | - Xueji Zhang
- Research Center for Bioengineering and Sensing Technology, University of Science and Technology Beijing, Beijing 100083, China
| | - Zhi-Xu He
- Department of Pediatrics, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China; Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Center & Sino-US Joint Laboratory for Medical Sciences, Laboratory Animal Center, Guiyang Medical University, Guiyang 550004, China.
| | - Shu-Feng Zhou
- Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL 33612, USA; Department of Bioengineering and Biotechnology, College of Chemical Engineering, Huaqiao University, Xiamen, Fujian 361021, China.
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Gallipoli P, Giotopoulos G, Huntly BJP. Epigenetic regulators as promising therapeutic targets in acute myeloid leukemia. Ther Adv Hematol 2015; 6:103-19. [PMID: 26137202 PMCID: PMC4480521 DOI: 10.1177/2040620715577614] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Acute myeloid leukemia (AML), the most prevalent acute leukemia in adults, is an aggressive hematological malignancy arising in hematopoietic stem and progenitor cells. With the exception of a few specific AML subtypes, the mainstays of treatment have not significantly changed over the last 20 years, and are still based on standard cytotoxic chemotherapy. As a result, clinical outcome remains poor for the majority of patients, with overall long-term survival in the region of 20-30%. Recent successes in characterizing the genetic landscape of AML have highlighted that, despite its heterogeneity, many cases of AML carry recurrent mutations in genes encoding epigenetic regulators. Transcriptional dysregulation and altered epigenetic function have therefore emerged as exciting areas in AML research and it is becoming increasingly clear that epigenetic dysfunction is central to leukemogenesis in AML. This has subsequently paved the way for the development of epigenetically targeted therapies. In this review, we will discuss the most recent advances in our understanding of the role of epigenetic dysregulation in AML pathobiology. We will particularly focus on those altered epigenetic programs that have been shown to be central to the development and maintenance of AML in preclinical models. We will discuss the recent development of therapeutics specifically targeting these key epigenetic programs in AML, describe their mechanism of action and present their current clinical development. Finally, we will discuss the opportunities presented by epigenetically targeted therapy in AML and will highlight future challenges ahead for the AML community, to ensure that these novel therapeutics are optimally translated into clinical practice and result in clinical improvement for AML patients.
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Affiliation(s)
- Paolo Gallipoli
- Department of Haematology, Cambridge Institute for Medical Research and Addenbrookes Hospital, University of Cambridge, Cambridge, UK
| | - George Giotopoulos
- Wellcome Trust-Medical Research Council, Cambridge Stem Cell Institute, Cambridge, UK
| | - Brian J P Huntly
- Department of Haematology, Cambridge Institute for Medical Research, University of Cambridge, Hills Road, Cambridge CB2 0XY, UK
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Kaur I, Constance JE, Kosak KM, Spigarelli MG, Sherwin CMT. An extensive pharmacokinetic, metabolic and toxicological review of elderly patients under intensive chemotherapy for acute myeloid leukemia. Expert Opin Drug Metab Toxicol 2014; 11:53-65. [DOI: 10.1517/17425255.2015.972934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Imit Kaur
- 1University of Utah School of Medicine, Division of Clinical Pharmacology, Department of Pediatrics, 295 Chipeta Way, Salt Lake City, UT 84108, USA ;
| | - Jonathan E Constance
- 1University of Utah School of Medicine, Division of Clinical Pharmacology, Department of Pediatrics, 295 Chipeta Way, Salt Lake City, UT 84108, USA ;
| | - Ken M Kosak
- 2University of Utah, Division of Hematology and Hematologic Malignancies and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Michael G Spigarelli
- 1University of Utah School of Medicine, Division of Clinical Pharmacology, Department of Pediatrics, 295 Chipeta Way, Salt Lake City, UT 84108, USA ;
| | - Catherine MT Sherwin
- 1University of Utah School of Medicine, Division of Clinical Pharmacology, Department of Pediatrics, 295 Chipeta Way, Salt Lake City, UT 84108, USA ;
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11
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Padilha SL, Souza EJDS, Matos MCC, Domino NR. Acute myeloid leukemia: survival analysis of patients at a university hospital of Paraná. Rev Bras Hematol Hemoter 2014; 37:21-7. [PMID: 25638763 PMCID: PMC4318841 DOI: 10.1016/j.bjhh.2014.11.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 06/16/2014] [Indexed: 12/31/2022] Open
Abstract
Objective The aim of this study was to analyze the prognostic factors correlated with survival of patients with acute myeloid leukemia at the Hospital de Clínicas, Universidade Federal do Paraná between 2003 and 2009, as well as to investigate the clinical and epidemiological profile. Methods The overall survival and disease-free survival were statistically evaluated using the Kaplan–Meier method, the log-rank test and multivariate evaluation by Cox regression analysis. Results The study population was predominantly younger than 60 years old (81,6%), had intermediate cytogenetic risk (40.8%), in first complete remission after induction chemotherapy (46.9%), with a white blood count at diagnosis of less than 30 × 109/L (57.1%) and de novo acute myeloid leukemia (62.2%). Survival curves showed that better prognosis was related to age below 60 years (median:12,4 months; p-value = 0,2227; Odds Ratio = 0,6676), good prognostic cytogenetic markers (median: 97.7 months; p-value = 0.0037; Odds Ratio = 0.4239) and white blood cell count at diagnosis of less than 30 × 109/L (median survival: 23.6 months; p-value = 0.0001; Odds Ratio = 0.3651). Regarding the French-American-British subgroups, the median overall survival was 23.5 months for M0, M1 and M2, 97.7 months for M3 and 7.4 months for M4, M5, M6, and M7 (p-value = 0.0288). Conclusion Prognostic factors strongly influenced patient survival, as well as guided treatment. Moreover, these factors were consistent with the available literature adjusted for the population in question.
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12
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Abstract
PURPOSE "Cure" is an important word in oncology but its use in the published literature has not been examined. I investigated all oncology articles using cure in the title field and published in 2012. The definition of cure was examined, specifically whether or not authors use the word to connote some surviving subset of patients who go on to experience outcomes similar to age-matched, normal controls-a definition favored by researchers and employed in survival function analyses. METHODS All articles published between January 1, 2012, and December 31, 2012, with the word cure in the title field were retrieved from Thompson Reuters' Web of Science. After exclusions, articles were read in full to examine what definitions of cure was used. Additionally, for each situation (type of cancer, stage/grade) where the word cure was used, a literature search was performed to ascertain whether there existed documented cases of cure. RESULTS Twenty-nine oncology articles used the word cure in their title in 2012. Nearly half, 14 (48%) of 29, used the term in situations (cancer type, stage/grade) currently considered incurable. Approximately one-third (34.5%) of the articles used the word consistent with the definition that, after a set period of time, some surviving subset of patients experience survival similar to normal controls. CONCLUSION There is heterogeneity in the use of the word cure in the literature.
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Affiliation(s)
- Vinay Prasad
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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