Differentiation therapy of acute myeloid leukemia: Past, present and future

Kevin Petrie, Arthur Z Zelent, Samuel Waxman

Research output: Contribution to journalArticle

125 Citations (Scopus)

Abstract

Purpose of review Since the 1970s, the concept of differentiation therapy has been viewed as a promising and revolutionary approach for the treatment of acute myeloid leukemia (AML) and other cancers. However, the successful clinical application of differentiation therapy has only been realized since the late 1980s and only in one subtype of AML, acute promyelocytic leukemia (APL). The use of all-trans-retinoic acid (ATRA) and arsenic trioxide, both of which induce degradation of the progressive multifocal leukoencephalopathy/retinoic acid receptor α oncoprotein, in combination with chemotherapy is currently the accepted treatment of APL, presenting a potential paradigm for differentiation therapy in clinical oncology. Recent findings We have begun to understand why ATRA fails to induce differentiation in AML The underlying reasons identified thus far are associated with an inability to target the removal of leukemogenic fusion proteins, aberrant epigenetic regulation of genes involved in the ATRA signaling pathway and the presence of factors that interfere with proper retinoic acid receptor α function. Summary Here, we examine the reasons why the exquisite sensitivity of APL to ATRA-based differentiation therapy has not been extended to other of AML subtypes. Current differentiation-based combinatorial approaches to target AML will also be analyzed. Finally, we will evaluate the potential of novel strategies, high-throughput screening, and functional genomics to uncover new differentiation-based therapies for AML.

Original languageEnglish (US)
Pages (from-to)84-91
Number of pages8
JournalCurrent Opinion in Hematology
Volume16
Issue number2
DOIs
StatePublished - Mar 2009
Externally publishedYes

Fingerprint

Acute Myeloid Leukemia
Tretinoin
Acute Promyelocytic Leukemia
Retinoic Acid Receptors
Therapeutics
Progressive Multifocal Leukoencephalopathy
Medical Oncology
Oncogene Proteins
Genomics
Combination Drug Therapy
Epigenomics
Genes
Neoplasms
Proteins

Keywords

  • Acute myeloid leukemia
  • All-trans-retinoic acid
  • Differentiation therapy
  • Retinoic acid receptor α

ASJC Scopus subject areas

  • Hematology

Cite this

Differentiation therapy of acute myeloid leukemia : Past, present and future. / Petrie, Kevin; Zelent, Arthur Z; Waxman, Samuel.

In: Current Opinion in Hematology, Vol. 16, No. 2, 03.2009, p. 84-91.

Research output: Contribution to journalArticle

Petrie, Kevin ; Zelent, Arthur Z ; Waxman, Samuel. / Differentiation therapy of acute myeloid leukemia : Past, present and future. In: Current Opinion in Hematology. 2009 ; Vol. 16, No. 2. pp. 84-91.
@article{3df956d3ec6f41dcbf718cb945e5a098,
title = "Differentiation therapy of acute myeloid leukemia: Past, present and future",
abstract = "Purpose of review Since the 1970s, the concept of differentiation therapy has been viewed as a promising and revolutionary approach for the treatment of acute myeloid leukemia (AML) and other cancers. However, the successful clinical application of differentiation therapy has only been realized since the late 1980s and only in one subtype of AML, acute promyelocytic leukemia (APL). The use of all-trans-retinoic acid (ATRA) and arsenic trioxide, both of which induce degradation of the progressive multifocal leukoencephalopathy/retinoic acid receptor α oncoprotein, in combination with chemotherapy is currently the accepted treatment of APL, presenting a potential paradigm for differentiation therapy in clinical oncology. Recent findings We have begun to understand why ATRA fails to induce differentiation in AML The underlying reasons identified thus far are associated with an inability to target the removal of leukemogenic fusion proteins, aberrant epigenetic regulation of genes involved in the ATRA signaling pathway and the presence of factors that interfere with proper retinoic acid receptor α function. Summary Here, we examine the reasons why the exquisite sensitivity of APL to ATRA-based differentiation therapy has not been extended to other of AML subtypes. Current differentiation-based combinatorial approaches to target AML will also be analyzed. Finally, we will evaluate the potential of novel strategies, high-throughput screening, and functional genomics to uncover new differentiation-based therapies for AML.",
keywords = "Acute myeloid leukemia, All-trans-retinoic acid, Differentiation therapy, Retinoic acid receptor α",
author = "Kevin Petrie and Zelent, {Arthur Z} and Samuel Waxman",
year = "2009",
month = "3",
doi = "10.1097/MOH.0b013e3283257aee",
language = "English (US)",
volume = "16",
pages = "84--91",
journal = "Current Opinion in Hematology",
issn = "1065-6251",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Differentiation therapy of acute myeloid leukemia

T2 - Past, present and future

AU - Petrie, Kevin

AU - Zelent, Arthur Z

AU - Waxman, Samuel

PY - 2009/3

Y1 - 2009/3

N2 - Purpose of review Since the 1970s, the concept of differentiation therapy has been viewed as a promising and revolutionary approach for the treatment of acute myeloid leukemia (AML) and other cancers. However, the successful clinical application of differentiation therapy has only been realized since the late 1980s and only in one subtype of AML, acute promyelocytic leukemia (APL). The use of all-trans-retinoic acid (ATRA) and arsenic trioxide, both of which induce degradation of the progressive multifocal leukoencephalopathy/retinoic acid receptor α oncoprotein, in combination with chemotherapy is currently the accepted treatment of APL, presenting a potential paradigm for differentiation therapy in clinical oncology. Recent findings We have begun to understand why ATRA fails to induce differentiation in AML The underlying reasons identified thus far are associated with an inability to target the removal of leukemogenic fusion proteins, aberrant epigenetic regulation of genes involved in the ATRA signaling pathway and the presence of factors that interfere with proper retinoic acid receptor α function. Summary Here, we examine the reasons why the exquisite sensitivity of APL to ATRA-based differentiation therapy has not been extended to other of AML subtypes. Current differentiation-based combinatorial approaches to target AML will also be analyzed. Finally, we will evaluate the potential of novel strategies, high-throughput screening, and functional genomics to uncover new differentiation-based therapies for AML.

AB - Purpose of review Since the 1970s, the concept of differentiation therapy has been viewed as a promising and revolutionary approach for the treatment of acute myeloid leukemia (AML) and other cancers. However, the successful clinical application of differentiation therapy has only been realized since the late 1980s and only in one subtype of AML, acute promyelocytic leukemia (APL). The use of all-trans-retinoic acid (ATRA) and arsenic trioxide, both of which induce degradation of the progressive multifocal leukoencephalopathy/retinoic acid receptor α oncoprotein, in combination with chemotherapy is currently the accepted treatment of APL, presenting a potential paradigm for differentiation therapy in clinical oncology. Recent findings We have begun to understand why ATRA fails to induce differentiation in AML The underlying reasons identified thus far are associated with an inability to target the removal of leukemogenic fusion proteins, aberrant epigenetic regulation of genes involved in the ATRA signaling pathway and the presence of factors that interfere with proper retinoic acid receptor α function. Summary Here, we examine the reasons why the exquisite sensitivity of APL to ATRA-based differentiation therapy has not been extended to other of AML subtypes. Current differentiation-based combinatorial approaches to target AML will also be analyzed. Finally, we will evaluate the potential of novel strategies, high-throughput screening, and functional genomics to uncover new differentiation-based therapies for AML.

KW - Acute myeloid leukemia

KW - All-trans-retinoic acid

KW - Differentiation therapy

KW - Retinoic acid receptor α

UR - http://www.scopus.com/inward/record.url?scp=62249169964&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=62249169964&partnerID=8YFLogxK

U2 - 10.1097/MOH.0b013e3283257aee

DO - 10.1097/MOH.0b013e3283257aee

M3 - Article

C2 - 19468269

AN - SCOPUS:62249169964

VL - 16

SP - 84

EP - 91

JO - Current Opinion in Hematology

JF - Current Opinion in Hematology

SN - 1065-6251

IS - 2

ER -