Title:Epigenetics and Adult Acute Myeloid Leukemia
Volume: 13
Issue: 2
Author(s): Maël Heiblig, Mohamed El Hamri, Gilles Salles and Xavier Thomas
Affiliation:
Keywords:
Acute myeloid leukemia, azacitidine, decitabine, epigenetics, hypomethylating agents, targeted therapies.
Abstract: Acute myeloid leukemia (AML) is the most common leukemia diagnosed in adults and
curative treatments remain currently a great challenge. AML occur in about 60% of patients over 60
years with unsatisfactory survival results, which have not improved significantly over the last two decades,
in spite of improved supportive care. Global genomic instability is the hallmark of the disease,
leading to chromosomal/molecular alterations, proliferative advantage and clonal heterogeneity. Epigenetic
deregulation of gene expression is considered as a consequence and/or the initiating cause of
this instability and DNA methylation is one of the most commonly occurring epigenetic events in this
setting. The plasticity of the epigenome, compared to the conserved status of the genome, designed it
as a therapeutic target especially in AML. Among novel therapeutic agents, the availability of compounds targeting epigenetic
modifiers offers the opportunity to have new therapeutic insights with improvement of outcome, especially in
older patients, while reducing toxicity. We reviewed herein some of the epigenetic mechanisms involved in normal hematopoiesis,
which may be deregulated in AML, and therapeutic potentials of cell re-programming.