tretinoin and Chromosome-Inversion

All-trans retinoic acid (ATRA)-based therapy for acute promyelocytic leukemia (APL), a subtype of acute myeloid leukemia (AML), is the most successful example of differentiation therapy. Although ATRA can induce differentiation in some non-APL AML cell lines and primary blasts, clinical results of adding ATRA to standard therapy in non-APL AML patients have been inconsistent, probably due to use of different regimens and lack of diagnostic tools for identifying which patients may be sensitive to ATRA. In this study, we exposed primary blasts obtained from non-APL AML patients to ATRA to test for differentiation potential in vitro. We observed increased expression of differentiation markers, indicating a response to ATRA, in four out of fifteen primary AML samples. Three samples in which CD11b increased in response to ATRA had an inversion of chromosome 16 as well as the CBFB-MYH11 fusion gene, and the fourth sample was from a patient with KMT2A-rearranged, therapy-related AML. In conclusion, we identified a subgroup of non-APL AML patients with inv(16) and CBFB-MYH11 as the most sensitive to ATRA-mediated differentiation in vitro, and our results can help identify patients who may benefit from ATRA treatment.

Topics: Antineoplastic Agents; Blast Crisis; CD11b Antigen; Cell Differentiation; Cell Line, Tumor; Chromosome Inversion; Chromosomes, Human, Pair 16; Core Binding Factor beta Subunit; Gene Fusion; Gene Rearrangement; Histone-Lysine N-Methyltransferase; Humans; Leukemia, Myeloid, Acute; Myeloid-Lymphoid Leukemia Protein; Myosin Heavy Chains; Tretinoin

Topics: Antineoplastic Agents; Biomarkers, Tumor; CCAAT-Enhancer-Binding Proteins; Chromosome Inversion; Decision Trees; Gene Expression Profiling; Gene Expression Regulation, Leukemic; Humans; Leukemia, Myeloid, Acute; Mutation; Precision Medicine; Predictive Value of Tests; Prognosis; Translocation, Genetic; Treatment Outcome; Tretinoin