1 5229 118 PRO-APOPTOTIC TP53 HOMOLOG TAP63 IS REPRESSED VIA EPIGENETIC SILENCING AND B-CELL RECEPTOR SIGNALLING IN CHRONIC LYMPHOCYTIC LEUKAEMIA. CHRONIC LYMPHOCYTIC LEUKAEMIA (CLL) IS AN ACCUMULATIVE DISORDER MARKED BY DEFICIENT APOPTOSIS. THE TP53 HOMOLOG TAP63 PROMOTES APOPTOSIS AND CHEMOSENSITIVITY IN SOLID TUMOURS AND ITS DEREGULATION MAY CONTRIBUTE TO CLL CELL SURVIVAL. WE FOUND THAT TAP63ALPHA WAS THE MOST PREVALENT TP63 ISOFORM IN CLL. COMPARED TO HEALTHY B CELLS, TAP63 MRNA WAS REPRESSED IN 55.7% OF CLL SAMPLES. TP63 PROMOTER METHYLATION WAS HIGH IN CLL AND INVERSELY CORRELATED WITH TP63 PROTEIN EXPRESSION IN B-CELL LYMPHOMA CELL LINES. SIRNA-MEDIATED KNOCKDOWN OF TP63 RESULTED IN PARTIAL PROTECTION FROM SPONTANEOUS APOPTOSIS ACCOMPANIED BY REDUCTIONS IN PMAIP1 (NOXA), BBC3 (PUMA), AND BAX MRNA IN CLL CELLS AND INCREASED PROLIFERATION OF RAJI LYMPHOMA CELLS. TAP63 MRNA LEVELS WERE HIGHER IN CLL WITH UNMUTATED IGHV. B-CELL RECEPTOR (BCR) ENGAGEMENT LED TO REPRESSION OF TP63 MRNA EXPRESSION IN MALIGNANT B CELLS, WHILE PHARMACOLOGICAL INHIBITION OF BCR SIGNALLING PREVENTED TP63 DOWNREGULATION. MIR21, KNOWN TO TARGET TAP63, CORRELATED INVERSELY WITH TAP63 EXPRESSION IN CLL, AND BCR-MEDIATED DOWNREGULATION OF TP63 WAS ACCOMPANIED BY MIR21 UPREGULATION IN MOST CLL SAMPLES. OUR DATA ILLUSTRATE THE PRO-APOPTOTIC FUNCTION OF TP63, PROVIDE INSIGHTS INTO THE MECHANISMS OF BCR-TARGETING AGENTS, AND ESTABLISH A RATIONALE FOR DESIGNING NOVEL APPROACHES TO INDUCE TP63 IN CLL AND B-CELL LYMPHOMA. 2013 2 2131 34 EPIGENETIC INACTIVATION OF THE HSA-MIR-203 IN HAEMATOLOGICAL MALIGNANCIES. MIR-203 IS A TUMOUR SUPPRESSOR MICRORNA (MIRNA). WE STUDIED THE METHYLATION OF HSA-MIR-203 IN 150 SAMPLES INCLUDING ACUTE MYELOID LEUKAEMIA (AML), ACUTE LYMPHOBLASTIC LEUKAEMIA (ALL), CHRONIC MYELOID LEUKAEMIA (CML), CHRONIC LYMPHOCYTIC LEUKAEMIA (CLL) AND NON-HODGKIN'S LYMPHOMA (NHL) BY METHYLATION-SPECIFIC PCR, AND MIRNA EXPRESSION BY STEM-LOOP RT-QPCR. HSA-MIR-203 PROMOTER WAS UNMETHYLATED IN NORMAL CONTROLS BUT HOMOZYGOUSLY METHYLATED IN TWO AML AND FOUR LYMPHOMA CELL LINES, IN WHICH 5-AZA-2'-DEOXYCYTIDINE TREATMENT LED TO PROMOTER DEMETHYLATION AND MIR-203 RE-EXPRESSION. RESTORATION OF MIR-203 EXPRESSION IN LYMPHOMA CELLS INHIBITED CELLULAR PROLIFERATION AND INCREASED CELL DEATH, SUGGESTING AN INHERENT TUMOUR SUPPRESSOR ACTIVITY. IN PRIMARY SAMPLES, HSA-MIR-203 METHYLATION WAS ABSENT IN CML BUT DETECTED IN 5.0% ALL, 10.0% AML, 42.0% CLL AND 38.8% OF NHL (INCLUDING SIX [60.0%] NATURAL KILLER-CELL, NINE [40.9%] B-CELL AND FOUR [23.5%] T CELL NHL). MOREOVER, HSA-MIR-203 METHYLATION WAS ASSOCIATED WITH HYPERMETHYLATION OF HSA-MIR-34A, -124A AND -196B IN NHL BUT NOT CLL. IN CLL, HSA-MIR-203 METHYLATION WAS ASSOCIATED WITH A HIGHER PRESENTING HB LEVEL (P = 0.033). THE PROJECTED 10 YEAR OVERALL SURVIVAL OF THE CLL PATIENTS WAS 58.2%, WHICH WAS IMPACTED BY RAI STAGE AND HIGH-RISK KARYOTYPES BUT NOT HSA-MIR-203 METHYLATION. HSA-MIR-203 WAS MORE FREQUENTLY METHYLATED IN LYMPHOID THAN MYELOID MALIGNANCIES (P = 0.002). IN CONCLUSION, MIR-203, A TUMOUR SUPPRESSOR GENE, WAS HYPERMETHYLATED IN A TUMOUR-SPECIFIC MANNER WITH GENE SILENCING. HSA-MIR-203 WAS MORE FREQUENTLY HYPERMETHYLATED IN LYMPHOID THAN MYELOID MALIGNANCIES. IN NHL, HSA-MIR-203 METHYLATION WAS ASSOCIATED WITH CONCOMITANT METHYLATION OF OTHER TUMOUR SUPPRESSOR MIRNAS. THE FREQUENT HSA-MIR-203 METHYLATION IN LYMPHOID MALIGNANCIES SUGGESTED A PATHOGENETIC ROLE OF HSA-MIR-203 METHYLATION. 2011 3 5924 19 TARGETING DNMT1 BY DEMETHYLATING AGENT OR-2100 INCREASES TYROSINE KINASE INHIBITORS-SENSITIVITY AND DEPLETES LEUKEMIC STEM CELLS IN CHRONIC MYELOID LEUKEMIA. ABL1 TYROSINE KINASE INHIBITORS (TKIS) DRAMATICALLY IMPROVE THE PROGNOSIS OF CHRONIC MYELOID LEUKEMIA (CML), BUT 10-20% OF PATIENTS ACHIEVE SUBOPTIMAL RESPONSES WITH LOW TKIS SENSITIVITY. FURTHERMORE, RESIDUAL LEUKEMIC STEM CELLS (LSCS) ARE INVOLVED IN THE MOLECULAR RELAPSE AFTER TKIS DISCONTINUATION. ABERRANT DNA HYPERMETHYLATION CONTRIBUTES TO LOW TKIS SENSITIVITY AND THE PERSISTENCE OF LSCS IN CML. DNMT1 IS A KEY REGULATOR OF HEMATOPOIETIC STEM CELLS, SUGGESTING THAT ABERRANT DNA HYPERMETHYLATION TARGETING DNMT1 REPRESENTS A POTENTIAL THERAPEUTIC TARGET FOR CML. WE INVESTIGATED THE EFFICACY OF OR-2100 (OR21), THE FIRST ORALLY AVAILABLE SINGLE-COMPOUND PRODRUG OF DECITABINE. OR21 EXHIBITED ANTI-TUMOR EFFECTS AS A MONOTHERAPY, AND IN COMBINATION THERAPY IT INCREASED TKI-INDUCED APOPTOSIS AND INDUCTION OF TUMOR SUPPRESSOR GENES INCLUDING PTPN6 ENCODING SHP-1 IN CML CELLS. OR21 IN COMBINATION WITH IMATINIB SIGNIFICANTLY SUPPRESSED TUMOR GROWTH IN A XENOTRANSPLANT MODEL. OR21 AND COMBINATION THERAPY DECREASED THE ABUNDANCE OF LSCS AND INHIBITED ENGRAFTMENT IN A BCR-ABL1-TRANSDUCED MOUSE MODEL. THESE RESULTS DEMONSTRATE THAT TARGETING DNMT1 USING OR21 EXERTS ANTI-TUMOR EFFECTS AND IMPAIRS LSCS IN CML. THEREFORE, COMBINATION TREATMENT OF TKIS AND OR21 REPRESENTS A PROMISING TREATMENT STRATEGY IN CML. 2022 4 2133 25 EPIGENETIC INACTIVATION OF THE MIR-34A IN HEMATOLOGICAL MALIGNANCIES. MIR-34A IS A TRANSCRIPTIONAL TARGET OF P53 AND IMPLICATED IN CARCINOGENESIS. WE STUDIED THE ROLE OF MIR-34A METHYLATION IN A PANEL OF HEMATOLOGICAL MALIGNANCIES INCLUDING ACUTE LEUKEMIA [ACUTE MYELOID LEUKEMIA (AML) AND ACUTE LYMPHOBLASTIC LEUKEMIA (ALL)], CHRONIC LEUKEMIA [CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) AND CHRONIC MYELOID LEUKEMIA (CML)], MULTIPLE MYELOMA (MM) AND NON-HODGKIN'S LYMPHOMA (NHL). THE METHYLATION STATUS OF MIR-34A PROMOTER WAS STUDIED IN 12 CELL LINES AND 188 DIAGNOSTIC SAMPLES BY METHYLATION-SPECIFIC POLYMERASE CHAIN REACTION. MIR-34A PROMOTER WAS UNMETHYLATED IN NORMAL CONTROLS BUT METHYLATED IN 75% LYMPHOMA AND 37% MYELOMA CELL LINES. HYPOMETHYLATING TREATMENT LED TO RE-EXPRESSION OF PRI-MIR-34A TRANSCRIPT IN LYMPHOMA CELLS WITH HOMOZYGOUS MIR-34A METHYLATION. IN PRIMARY SAMPLES AT DIAGNOSIS, MIR-34A METHYLATION WAS DETECTED IN 4% CLL, 5.5% MM SAMPLES AND 18.8% OF NHL AT DIAGNOSIS BUT NONE OF ALL, AML AND CML (P = 0.011). IN MM PATIENTS WITH PAIRED SAMPLES, MIR-34A METHYLATION STATUS REMAINED UNCHANGED AT PROGRESSION. AMONGST LYMPHOID MALIGNANCIES, MIR-34A WAS PREFERENTIALLY METHYLATED IN NHL (P = 0.018), IN PARTICULAR NATURAL KILLER (NK)/T-CELL LYMPHOMA. IN CONCLUSION, AMONGST HEMATOLOGICAL MALIGNANCIES, MIR-34A METHYLATION IS PREFERENTIALLY HYPERMETHYLATED IN NHL, IN PARTICULAR NK/T-CELL LYMPHOMA, IN A TUMOR-SPECIFIC MANNER, THEREFORE THE ROLE OF MIR-34A IN LYMPHOMAGENESIS WARRANTS FURTHER STUDY. 2010 5 2129 27 EPIGENETIC INACTIVATION OF SUPPRESSORS OF CYTOKINE SIGNALLING IN PHILADELPHIA-NEGATIVE CHRONIC MYELOPROLIFERATIVE DISORDERS. PH-NEGATIVE CHRONIC MYELOPROLIFERATIVE DISORDERS (CMPD) ARE CHARACTERIZED BY CONSTITUTIVE JANUS KINASE-SIGNAL TRANSDUCER AND ACTIVATOR OF TRANSCRIPTION (JAK-STAT) ACTIVATION. SOCS3, SOCS1 AND PTPN6 (SHP1) ARE NEGATIVE REGULATORS OF THE JAK-STAT PATHWAY. WE INVESTIGATED EPIGENETIC AND GENETIC INACTIVATION OF SOCS3, SOCS1 AND PTPN6 IN 112 CMPD AND 20 ACUTE MYELOID LEUKAEMIA (AML) POST-CMPD. SOCS3 METHYLATION OCCURRED AT HIGH FREQUENCY IN BOTH CMPD (46/112; 41.1%) AND AML POST-CMPD (10/17; 58.8%) AND WAS ASSOCIATED WITH TRANSCRIPTIONAL SILENCING. IN CONTRAST, METHYLATION OF SOCS1 AND PTPN6 WAS OBSERVED IN ONLY A FRACTION OF CMPD (15/112, 13.4% FOR SOCS1; AND 8/112, 7.1% FOR PTPN6) AND AML POST-CMPD (3/20, 15% FOR SOCS1; AND 1/20, 5% FOR PTPN6). NO SOMATIC MUTATIONS OF SOCS1 WERE FOUND IN CMPD. SOCS3, SOCS1 AND PTPN6 METHYLATION OCCURRED IN BOTH JAK2V617F-POSITIVE (35.1% FOR SOCS3; 14.9% FOR SOCS1; 8.1% FOR PTPN6) AND JAK2V617F-NEGATIVE (57.1% FOR SOCS3; 14.3% FOR SOCS1; AND 9.5% FOR PTPN6) CMPD. THESE DATA INDICATE THAT METHYLATION OF SOCS3 AND, TO A LESSER EXTENT, SOCS1 AND PTPN6 IS A FREQUENT EVENT IN BOTH JAK2V617F-POSITIVE AND -NEGATIVE CMPD AND MAY ACT AS AN ALTERNATIVE OR COMPLEMENTARY MECHANISM TO JAK2 MUTATIONS, ENHANCING CYTOKINE SIGNAL TRANSDUCTION. THE FREQUENT INACTIVATION OF SOCS3 IS A NOVEL FINDING IN CMPD WITH POTENTIAL IMPLICATIONS FOR THE MOLECULAR PATHOLOGY OF THESE DISORDERS. 2008 6 5911 18 TARGETED NEXT-GENERATION SEQUENCING IN MYELODYSPLASTIC SYNDROME AND CHRONIC MYELOMONOCYTIC LEUKEMIA AIDS DIAGNOSIS IN CHALLENGING CASES AND IDENTIFIES FREQUENT SPLICEOSOME MUTATIONS IN TRANSFORMED ACUTE MYELOID LEUKEMIA. OBJECTIVES: OPTIMAL INTEGRATION OF NEXT-GENERATION SEQUENCING (NGS) INTO CLINICAL PRACTICE IN HEMATOLOGIC MALIGNANCIES REMAINS UNCLEAR. WE EVALUATE THE UTILITY OF NGS IN MYELOID MALIGNANCIES. METHODS: A 42-GENE PANEL WAS USED TO SEQUENCE 109 CASES OF MYELODYSPLASTIC SYNDROME (MDS, N = 38), CHRONIC MYELOMONOCYTIC LEUKEMIA (CMML, N = 14), MYELOPROLIFERATIVE NEOPLASM (MPN, N = 24), AND MDS AND/OR MPN TRANSFORMED TO ACUTE MYELOID LEUKEMIA (AML, N = 33). RESULTS: AT LEAST ONE PATHOGENIC MUTATION WAS IDENTIFIED IN 74% OF CASES OF MDS, 100% OF CMMLS, AND 96% OF MPNS. IN CONTRAST, ONLY 47% OF CASES OF MDS (18/38) AND 7% (1/14) OF CMMLS EXHIBITED ABNORMAL CYTOGENETICS. IN DIAGNOSTICALLY DIFFICULT CASES OF MDS OR CMML WITH NORMAL CYTOGENETICS, NGS IDENTIFIED A PATHOGENIC MUTATION AND WAS CRITICAL IN ESTABLISHING THE CORRECT DIAGNOSIS. SPLICEOSOMAL GENES AND EPIGENETIC MODIFIERS WERE FREQUENTLY MUTATED. SPLICEOSOME MUTATIONS WERE ALSO FREQUENTLY DETECTED IN AML ARISING FROM MDS, CMML, OR MPN (39%) COMPARED WITH THE REPORTED RATE IN DE NOVO AML (7%-14%). CONCLUSIONS: IN DIFFICULT CASES OF MDS OR MPN, NGS FACILITATES DIAGNOSIS BY DETECTION OF GENE MUTATIONS TO CONFIRM CLONALITY, AND AMLS EVOLVING FROM MDS OR MPN CARRY FREQUENT MUTATIONS IN SPLICEOSOMAL GENES. 2016 7 2134 38 EPIGENETIC INACTIVATION OF THE MIR129-2 IN HEMATOLOGICAL MALIGNANCIES. BACKGROUND: MIR129-2 HAS BEEN SHOWN TO BE A TUMOR SUPPRESSOR MICRORNA HYPERMETHYLATED IN EPITHELIAL CANCERS. PATIENTS AND METHODS: EPIGENETIC INACTIVATION OF MIR129-2 WAS STUDIED BY METHYLATION-SPECIFIC PCR (MSP) IN 13 CELL LINES (EIGHT MYELOMA AND FIVE LYMPHOMA), 15 NORMAL CONTROLS AND 344 PRIMARY SAMPLES INCLUDING ACUTE MYELOID LEUKEMIA (AML), ACUTE LYMPHOBLASTIC LEUKEMIA (ALL), CHRONIC MYELOID LEUKEMIA (CML), CHRONIC LYMPHOCYTIC LEUKEMIA (CLL), NON-HODGKIN'S LYMPHOMA (NHL), MULTIPLE MYELOMA (MM) AT DIAGNOSIS, MM AT RELAPSE/PROGRESSION, AND MONOCLONAL GAMMOPATHY OF UNDETERMINED SIGNIFICANCE (MGUS). EXPRESSION OF MIR129 AND ITS TARGET, SOX4, IN CELL LINES WAS MEASURED BEFORE AND AFTER HYPOMETHYLATING TREATMENT AND MIR129 OVEREXPRESSION. MIR129 EXPRESSION WAS CORRELATED WITH MIR129-2 METHYLATION STATUS IN PRIMARY LYMPHOMA SAMPLES. TUMOR SUPPRESSOR FUNCTION OF MIR129 WAS DEMONSTRATED BY MTT AND TRYPAN BLUE EXCLUSION ASSAY AFTER MIR129 OVEREXPRESSION. RESULTS: THE SENSITIVITY OF THE METHYLATED-MSP WAS ONE IN 10(3). DIFFERENT MSP STATUSES, INCLUDING COMPLETE METHYLATION, PARTIAL METHYLATION, AND COMPLETE UNMETHYLATION, WERE VERIFIED BY QUANTITATIVE BISULFITE PYROSEQUENCING. ALL FIVE LYMPHOMA AND SEVEN OF EIGHT MYELOMA CELL LINES SHOWED COMPLETE AND PARTIAL MIR129-2 METHYLATION. IN PRIMARY SAMPLES, MIR129-2 METHYLATION WAS ABSENT IN AML AND CML, BUT DETECTED IN 5% ALL, 45.9% CLL, 49.5% MM AT DIAGNOSIS, AND 59.1% NHL. IN CLL, MIR129-2 METHYLATION ADVERSELY IMPACTED ON SURVIVAL (P=0.004). IN MM, MIR129-2 METHYLATION INCREASED FROM 27.5% MGUS TO 49.5% MM AT DIAGNOSIS AND 41.5% AT RELAPSE/PROGRESSION (P=0.023). IN NHL, MIR129-2 METHYLATION WAS ASSOCIATED WITH MIR124-1 AND MIR203 METHYLATION (P<0.001), AND LOWER MIR129 EXPRESSION (P=0.009). HYPOMETHYLATION TREATMENT OF JEKO-1, HOMOZYGOUSLY METHYLATED FOR MIR129-2, LED TO MIR129-2 DEMETHYLATION AND MIR129 RE-EXPRESSION, WITH DOWNREGULATION OF SOX4 MRNA. MOREOVER, MIR129 OVEREXPRESSION IN BOTH MANTLE CELL LINES, JEKO-1 AND GRANTA-519, INHIBITED CELLULAR PROLIFERATION AND ENHANCED CELL DEATH, WITH CONCOMITANT SOX4 MRNA DOWNREGULATION. CONCLUSIONS: MIR129-2 IS A TUMOR SUPPRESSIVE MICRORNA FREQUENTLY METHYLATED IN LYMPHOID BUT NOT MYELOID MALIGNANCIES, LEADING TO REVERSIBLE MIR129-2 SILENCING. IN CLL, MIR129-2 METHYLATION WAS ASSOCIATED WITH AN INFERIOR SURVIVAL. IN MM, MIR129-2 METHYLATION MIGHT BE ACQUIRED DURING PROGRESSION FROM MGUS TO SYMPTOMATIC MM. IN NHL, MIR129-2 METHYLATION MIGHT COLLABORATE WITH MIR124-1 AND MIR203 METHYLATION IN LYMPHOMAGENESIS. 2013 8 2127 34 EPIGENETIC INACTIVATION OF MIR-9 FAMILY MICRORNAS IN CHRONIC LYMPHOCYTIC LEUKEMIA--IMPLICATIONS ON CONSTITUTIVE ACTIVATION OF NFKAPPAB PATHWAY. BACKGROUND: THE MIR-9 FAMILY MICRORNAS HAVE BEEN IDENTIFIED AS A TUMOR SUPPRESSOR MIRNA IN CANCERS. WE POSTULATED THAT MIR-9-1, MIR-9-2 AND MIR-9-3 MIGHT BE INACTIVATED BY DNA HYPERMETHYLATION IN CHRONIC LYMPHOCYTIC LEUKEMIA (CLL). METHODS: METHYLATION OF MIR-9-1, MIR-9-2 AND MIR-9-3 WAS STUDIED IN EIGHT NORMAL CONTROLS INCLUDING NORMAL BONE MARROW, BUFFY COAT, AND CD19-SORTED PERIPHERAL BLOOD B-CELLS FROM HEALTHY INDIVIDUALS, SEVEN CLL CELL LINES, AND SEVENTY-EIGHT DIAGNOSTIC CLL SAMPLES BY METHYLATION-SPECIFIC POLYMERASE CHAIN REACTION. RESULTS: THE PROMOTERS OF MIR-9-3 AND MIR-9-1 WERE BOTH UNMETHYLATED IN NORMAL CONTROLS, BUT METHYLATED IN FIVE (71.4%) AND ONE OF SEVEN CLL CELL LINES RESPECTIVELY. HOWEVER, MIR-9-2 PROMOTER WAS METHYLATED IN NORMAL CONTROLS INCLUDING CD19 + VE B-CELLS, HENCE SUGGESTIVE OF A TISSUE-SPECIFIC BUT NOT TUMOR-SPECIFIC METHYLATION, AND THUS NOT FURTHER STUDIED. DIFFERENT MSP STATUSES OF MIR-9-3, INCLUDING COMPLETE METHYLATION, PARTIAL METHYLATION, AND COMPLETE UNMETHYLATION, WERE VERIFIED BY QUANTITATIVE BISULFITE METHYLATION ANALYSIS. 5-AZA-2'-DEOXYCYTIDINE TREATMENT RESULTED IN MIR-9-3 PROMOTER DEMETHYLATION AND RE-EXPRESSION OF PRI-MIR-9-3 IN I83-E95 AND WAC3CD5+ CELLS, WHICH WERE HOMOZYGOUSLY METHYLATED FOR MIR-9-3. MOREOVER, OVEREXPRESSION OF MIR-9 LED TO SUPPRESSED CELL PROLIFERATION AND ENHANCED APOPTOSIS TOGETHER WITH DOWNREGULATION OF NFKAPPAB1 IN I83-E95 CELLS, SUPPORTING A TUMOR SUPPRESSOR ROLE OF MIR-9-3 IN CLL. IN PRIMARY CLL SAMPLES, MIR-9-3 WAS DETECTED IN 17% AND MIR-9-1 METHYLATION IN NONE OF THE PATIENTS AT DIAGNOSIS. MOREOVER, MIR-9-3 METHYLATION WAS ASSOCIATED WITH ADVANCED RAI STAGE (>/= STAGE 2) (P = 0.04). CONCLUSIONS: OF THE MIR-9 FAMILY, MIR-9-3 IS A TUMOR SUPPRESSOR MIRNA RELATIVELY FREQUENTLY METHYLATED, AND HENCE SILENCED IN CLL; WHEREAS MIR-9-1 METHYLATION IS RARE IN CLL. THE ROLE OF MIR-9-3 METHYLATION IN THE CONSTITUTIVE ACTIVATION OF NFKAPPAB SIGNALING PATHWAY IN CLL WARRANTS FURTHER STUDY. 2013 9 573 34 BCR-ABL1-INDUCED DOWNREGULATION OF WASP IN CHRONIC MYELOID LEUKEMIA INVOLVES EPIGENETIC MODIFICATION AND CONTRIBUTES TO MALIGNANCY. CHRONIC MYELOID LEUKEMIA (CML) IS A MYELOPROLIFERATIVE DISEASE CAUSED BY THE BCR-ABL1 TYROSINE KINASE (TK). THE DEVELOPMENT OF TK INHIBITORS (TKIS) REVOLUTIONIZED THE TREATMENT OF CML PATIENTS. HOWEVER, TKIS ARE NOT EFFECTIVE TO THOSE AT ADVANCED PHASES WHEN AMPLIFIED BCR-ABL1 LEVELS AND INCREASED GENOMIC INSTABILITY LEAD TO SECONDARY ONCOGENIC MODIFICATIONS. WISKOTT-ALDRICH SYNDROME PROTEIN (WASP) IS AN IMPORTANT REGULATOR OF SIGNALING TRANSDUCTION IN HEMATOPOIETIC CELLS AND WAS SHOWN TO BE AN ENDOGENOUS INHIBITOR OF THE C-ABL TK. HERE, WE SHOW THAT THE EXPRESSION OF WASP DECREASES WITH THE PROGRESSION OF CML, INVERSELY CORRELATES WITH THE EXPRESSION OF BCR-ABL1 AND IS PARTICULARLY LOW IN BLAST CRISIS. ENFORCED EXPRESSION OF BCR-ABL1 NEGATIVELY REGULATES THE EXPRESSION OF WASP. DECREASED EXPRESSION OF WASP IS PARTIALLY DUE TO DNA METHYLATION OF THE PROXIMAL WASP PROMOTER. IMPORTANTLY, LOWER LEVELS OF WASP IN CML ADVANCED PHASE PATIENTS CORRELATE WITH POORER OVERALL SURVIVAL (OS) AND IS ASSOCIATED WITH TKI RESPONSE. INTERESTINGLY, ENFORCED EXPRESSION OF WASP IN BCR-ABL1-POSITIVE K562 CELLS INCREASES THE SUSCEPTIBILITY TO APOPTOSIS INDUCED BY TRAIL OR CHEMOTHERAPEUTIC DRUGS AND NEGATIVELY MODULATES BCR-ABL1-INDUCED TUMORIGENESIS IN VITRO AND IN VIVO. TAKEN TOGETHER, OUR DATA REVEAL A NOVEL MOLECULAR MECHANISM THAT OPERATES IN BCR-ABL1-INDUCED TUMORIGENESIS THAT CAN BE USED TO DEVELOP NEW STRATEGIES TO HELP TKI-RESISTANT, CML PATIENTS IN BLAST CRISIS (BC). 2017 10 4553 20 MUTATIONAL LANDSCAPE OF CHRONIC MYELOMONOCYTIC LEUKEMIA IN CHINESE PATIENTS. BACKGROUND: CHRONIC MYELOMONOCYTIC LEUKEMIA (CMML) IS A RARE AND HETEROGENEOUS HEMATOLOGICAL MALIGNANCY. IT HAS BEEN SHOWN THAT THE MOLECULAR ABNORMALITIES SUCH AS ASXL1, TET2, SETBP1, AND SRSF2 MUTATIONS ARE COMMON IN CAUCASIAN POPULATION. METHODS: WE RETROSPECTIVELY ANALYZED 178 CHINESE CMML PATIENTS. THE TARGETED NEXT GENERATION SEQUENCING (NGS) WAS USED TO EVALUATE 114 GENE VARIATIONS, AND THE PROGNOSTIC FACTORS FOR OS WERE DETERMINED BY COX REGRESSION ANALYSIS. RESULTS: THE CMML PATIENTS SHOWED A UNIQUE MUTATIONAL SPECTRUM, INCLUDING TET2 (36.5%), NRAS (31.5%), ASXL1 (28.7%), SRSF2 (24.7%), AND RUNX1 (21.9%). OF THE 102 PATIENTS WITH CLONAL ANALYSIS, THE ANCESTRAL EVENTS PREFERENTIALLY OCCURRED IN TET2 (18.5%), SPLICING FACTORS (16.5%), RAS (14.0%), AND ASXL1 (7.8%), AND THE SUBCLONAL GENES WERE MAINLY ASXL1, TET2, AND RAS. IN ADDITION, THE SECONDARY ACUTE MYELOID LEUKEMIA (SAML) TRANSFORMED FROM CMML OFTEN HAD MUTATIONS IN DNMT3A, ETV6, FLT3, AND NPM1, WHILE THE PRIMARY AML (PAML) DEMONSTRATED MORE MUTATIONS IN CEBPA, DNMT3A, FLT3, IDH1/2, NPM1, AND WT1. IT WAS OF NOTE THAT A SERIES OF CLONES WERE EMERGED DURING THE PROGRESSION FROM CMML TO AML, INCLUDING DNMT3A, FLT3, AND NPM1. BY UNIVARIATE ANALYSIS, ASXL1 MUTATION, INTERMEDIATE- AND HIGH-RISK CYTOGENETIC ABNORMALITY, CMML-SPECIFIC PROGNOSTIC SCORING SYSTEM (CPSS) STRATIFICATIONS (INTERMEDIATE-2 AND HIGH GROUP), AND TREATMENT OPTIONS (BEST SUPPORTIVE CARE) PREDICTED FOR WORSE OS. MULTIVARIATE ANALYSIS REVEALED A SIMILAR OUTCOME. CONCLUSIONS: THE COMMON MUTATIONS IN CHINESE CMML PATIENTS INCLUDED EPIGENETIC MODIFIERS (TET2 AND ASXL1), SIGNALING TRANSDUCTION PATHWAY COMPONENTS (NRAS), AND SPLICING FACTOR (SRSF2). THE CMML PATIENTS WITH DNMT3A, ETV6, FLT3, AND NPM1 MUTATIONS TENDED TO PROGRESS TO SAML. ASXL1 MUTATION AND THERAPEUTIC MODALITIES WERE INDEPENDENT PROGNOSTIC FACTORS FOR CMML. 2022 11 2888 29 GAIN-OF-FUNCTION MUTATION OF GATA-2 IN ACUTE MYELOID TRANSFORMATION OF CHRONIC MYELOID LEUKEMIA. ACQUISITION OF ADDITIONAL GENETIC AND/OR EPIGENETIC ABNORMALITIES OTHER THAN THE BCR/ABL FUSION GENE IS BELIEVED TO CAUSE DISEASE PROGRESSION IN CHRONIC MYELOID LEUKEMIA (CML) FROM CHRONIC PHASE TO BLAST CRISIS (BC). TO GAIN INSIGHTS INTO THE UNDERLYING MECHANISMS OF PROGRESSION TO BC, WE SCREENED DNA SAMPLES FROM CML PATIENTS DURING BLAST TRANSFORMATION FOR MUTATIONS IN A NUMBER OF TRANSCRIPTION FACTOR GENES THAT ARE CRITICAL FOR MYELOID-LYMPHOID DEVELOPMENT. IN 85 CASES OF CML BLAST TRANSFORMATION, WE IDENTIFIED TWO NEW MUTATIONS IN THE CODING REGION OF GATA-2, A NEGATIVE REGULATOR OF HEMATOPOIETIC STEM/PROGENITOR CELL DIFFERENTIATION. A L359V SUBSTITUTION WITHIN ZINC FINGER DOMAIN (ZF) 2 OF GATA-2 WAS FOUND IN EIGHT CASES WITH MYELOMONOBLASTIC FEATURES, WHEREAS AN IN-FRAME DELETION OF 6 AA (DELTA341-346) SPANNING THE C-TERMINAL BORDER OF ZF1 WAS DETECTED IN ONE PATIENT AT MYELOID BC WITH EOSINOPHILIA. FURTHER STUDIES INDICATED THAT L359V NOT ONLY INCREASED TRANSACTIVATION ACTIVITY OF GATA-2 BUT ALSO ENHANCED ITS INHIBITORY EFFECTS ON THE ACTIVITY OF PU.1, A MAJOR REGULATOR OF MYELOPOIESIS. CONSISTENT WITH THE MYELOMONOBLASTIC FEATURES OF CML TRANSFORMATION WITH THE GATA-2 L359V MUTANT, TRANSDUCTION OF THE GATA-2 L359V MUTANT INTO HL-60 CELLS OR BCR/ABL-HARBORING MURINE CELLS DISTURBED MYELOMONOCYTIC DIFFERENTIATION/PROLIFERATION IN VITRO AND IN VIVO, RESPECTIVELY. THESE DATA STRONGLY SUGGEST THAT GATA-2 MUTATIONS MAY PLAY A ROLE IN ACUTE MYELOID TRANSFORMATION IN A SUBSET OF CML PATIENTS. 2008 12 5940 27 TARGETING METHYLTRANSFERASE PRMT5 ELIMINATES LEUKEMIA STEM CELLS IN CHRONIC MYELOGENOUS LEUKEMIA. IMATINIB-INSENSITIVE LEUKEMIA STEM CELLS (LSCS) ARE BELIEVED TO BE RESPONSIBLE FOR RESISTANCE TO BCR-ABL TYROSINE KINASE INHIBITORS AND RELAPSE OF CHRONIC MYELOGENOUS LEUKEMIA (CML). IDENTIFYING THERAPEUTIC TARGETS TO ERADICATE CML LSCS MAY BE A STRATEGY TO CURE CML. IN THE PRESENT STUDY, WE DISCOVERED A POSITIVE FEEDBACK LOOP BETWEEN BCR-ABL AND PROTEIN ARGININE METHYLTRANSFERASE 5 (PRMT5) IN CML CELLS. OVEREXPRESSION OF PRMT5 WAS OBSERVED IN HUMAN CML LSCS. SILENCING PRMT5 WITH SHRNA OR BLOCKING PRMT5 METHYLTRANSFERASE ACTIVITY WITH THE SMALL-MOLECULE INHIBITOR PJ-68 REDUCED SURVIVAL, SERIAL REPLATING CAPACITY, AND LONG-TERM CULTURE-INITIATING CELLS (LTC-ICS) IN LSCS FROM CML PATIENTS. FURTHER, PRMT5 KNOCKDOWN OR PJ-68 TREATMENT DRAMATICALLY PROLONGED SURVIVAL IN A MURINE MODEL OF RETROVIRAL BCR-ABL-DRIVEN CML AND IMPAIRED THE IN VIVO SELF-RENEWAL CAPACITY OF TRANSPLANTED CML LSCS. PJ-68 ALSO INHIBITED LONG-TERM ENGRAFTMENT OF HUMAN CML CD34+ CELLS IN IMMUNODEFICIENT MICE. MOREOVER, INHIBITION OF PRMT5 ABROGATED THE WNT/BETA-CATENIN PATHWAY IN CML CD34+ CELLS BY DEPLETING DISHEVELLED HOMOLOG 3 (DVL3). THIS STUDY SUGGESTS THAT EPIGENETIC METHYLATION MODIFICATION ON HISTONE PROTEIN ARGININE RESIDUES IS A REGULATORY MECHANISM TO CONTROL SELF-RENEWAL OF LSCS AND INDICATES THAT PRMT5 MAY REPRESENT A POTENTIAL THERAPEUTIC TARGET AGAINST LSCS. 2016 13 1286 24 DECITABINE IN COMBINATION WITH DONOR LYMPHOCYTE INFUSIONS CAN INDUCE REMISSIONS IN RELAPSED MYELOID MALIGNANCIES WITH HIGHER LEUKEMIC BURDEN AFTER ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANTATION. THE COMBINATION OF 5-AZACYTIDINE (AZA) WITH DONOR LYMPHOCYTE INFUSIONS (DLIS) CAN INDUCE REMISSIONS IN PATIENTS WITH RELAPSED MYELOID MALIGNANCIES AFTER ALLO-HCT. AS DECITABINE (DAC) IS KNOWN TO BE EFFECTIVE ALSO IN AML/MDS WITH LEUKOCYTOSIS, WE INVESTIGATED THE COMBINATION OF DAC WITH DLIS FOR RELAPSE AFTER ALLO-HCT. BETWEEN 2006 AND 2016, 26 PATIENTS (MEDIAN AGE 59 YEARS) WITH AML (N = 18), MDS (N = 6), OR MPN (N = 2) AND OVERT HEMATOLOGICAL RELAPSE AFTER ALLO-HCT WERE TREATED. MEDIAN DURATION FROM ALLO-HCT TO RELAPSE WAS 306 DAYS (RANGE, 76-4943). EIGHTEEN PATIENTS RECEIVED DAC + DLIS, 8 DAC-ONLY (MEDIAN NUMBER CYCLES OF DAC: 2, RANGE 1-13, MEDIAN NUMBER OF DLIS: 2, RANGE 1-10). THE INCIDENCE OF ACUTE AND CHRONIC GVHD IN PATIENTS RECEIVING DLI WAS 17% (3/18) AND 6% (1/18), RESPECTIVELY. CR/CRI WAS ACHIEVED IN 15% (4/26), PR IN 4% (1/26), AND STABLE DISEASE IN 58% (15/26) OF PATIENTS. EIGHT PATIENTS RECEIVED A SECOND ALLO-HCT. MEDIAN OVERALL SURVIVAL WAS 4.7 MONTHS. ELEVATED PD-L1 PROTEIN EXPRESSION IN BONE MARROW CELLS WAS DETECTED IN 4/8 PATIENTS WITH >20% BLAST INFILTRATION PRIOR TO DAC, WITHOUT A CLEAR ASSOCIATION WITH RESPONSE. IN CONCLUSION, THE DAC + DLI REGIMEN PROVED FEASIBLE AND EFFECTIVE IN RELAPSED MYELOID MALIGNANCIES AFTER ALLO-HCT, WITH EFFICACY NOT RESTRICTED TO PATIENTS WITH LOW LEUKEMIC BURDEN. 2018 14 3168 22 GTPASE REGULATOR ASSOCIATED WITH THE FOCAL ADHESION KINASE (GRAF) TRANSCRIPT WAS DOWN-REGULATED IN PATIENTS WITH MYELOID MALIGNANCIES. BACKGROUND: GTPASE REGULATOR ASSOCIATED WITH THE FOCAL ADHESION KINASE (GRAF), A PUTATIVE TUMOR SUPPRESSOR GENE, IS FOUND INACTIVATED IN HEMATOPOIETIC MALIGNANCIES BY EITHER GENETIC OR EPIGENETIC ABNORMALITIES. HOWEVER, THE EXPRESSION LEVEL OF GRAF GENE HAS NOT YET BEEN STUDIED IN LEUKEMIA. THE AIM OF THIS STUDY WAS TO INVESTIGATE THE EXPRESSION LEVEL OF GRAF GENE IN THOSE PATIENTS WITH MYELOID MALIGNANCIES INCLUDING ACUTE MYELOID LEUKEMIA (AML), MYELODYSPLASTIC SYNDROME (MDS) AND CHRONIC MYELOID LEUKEMIA (CML). METHODS: THE EXPRESSION LEVELS OF GRAF TRANSCRIPT WERE DETERMINED IN 94 PATIENTS USING REAL-TIME QUANTITATIVE PCR (RQ-PCR). CLINICAL AND LABORATORY DATA OF THESE PATIENTS WERE COLLECTED AND ANALYZED. RESULTS: THE SIGNIFICANTLY DECREASED LEVEL OF GRAF TRANSCRIPT WAS OBSERVED IN THREE MYELOID MALIGNANCIES COMPARED TO CONTROLS. WITHIN AML, THERE WAS NO DIFFERENCE IN THE LEVEL OF GRAF TRANSCRIPT AMONG DIFFERENT FAB SUBTYPES (P > 0.05). DIFFERENCE WAS NOT OBSERVED IN THE AMOUNT OF GRAF MRNA BETWEEN CML AT CHRONIC PHASE AND CONTROLS. AS CML PROGRESSED, GRAF TRANSCRIPT SIGNIFICANTLY DECREASED. IN MDS, THREE CASES WITH 5Q DELETION HAD LOWER GRAF TRANSCRIPT THAN FOUR WITHOUT 5Q DELETION (MEDIAN 0.76 VS 2.99) (P > 0.05). CONCLUSION: OUR RESULTS DEMONSTRATE THAT THE GRAF TRANSCRIPT IS DECREASED IN MYELOID MALIGNANCIES. 2010 15 4556 21 MUTATIONAL SPECTRUM OF MYELOID MALIGNANCIES WITH INV(3)/T(3;3) REVEALS A PREDOMINANT INVOLVEMENT OF RAS/RTK SIGNALING PATHWAYS. MYELOID MALIGNANCIES BEARING CHROMOSOMAL INV(3)/T(3;3) ABNORMALITIES ARE AMONG THE MOST THERAPY-RESISTANT LEUKEMIAS. DEREGULATED EXPRESSION OF EVI1 IS THE MOLECULAR HALLMARK OF THIS DISEASE; HOWEVER, THE GENOME-WIDE SPECTRUM OF COOPERATING MUTATIONS IN THIS DISEASE SUBSET HAS NOT BEEN SYSTEMATICALLY ELUCIDATED. HERE, WE SHOW THAT 98% OF INV(3)/T(3;3) MYELOID MALIGNANCIES HARBOR MUTATIONS IN GENES ACTIVATING RAS/RECEPTOR TYROSINE KINASE (RTK) SIGNALING PATHWAYS. IN ADDITION, HEMIZYGOUS MUTATIONS IN GATA2, AS WELL AS HETEROZYGOUS ALTERATIONS IN RUNX1, SF3B1, AND GENES ENCODING EPIGENETIC MODIFIERS, FREQUENTLY CO-OCCUR WITH THE INV(3)/T(3;3) ABERRATION. NOTABLY, NEITHER MUTATIONAL PATTERNS NOR GENE EXPRESSION PROFILES DIFFER ACROSS INV(3)/T(3;3) ACUTE MYELOID LEUKEMIA, CHRONIC MYELOID LEUKEMIA, AND MYELODYSPLASTIC SYNDROME CASES, SUGGESTING RECOGNITION OF INV(3)/T(3;3) MYELOID MALIGNANCIES AS A SINGLE DISEASE ENTITY IRRESPECTIVE OF BLAST COUNT. THE HIGH INCIDENCE OF ACTIVATING RAS/RTK SIGNALING MUTATIONS MAY PROVIDE A TARGET FOR A RATIONAL TREATMENT STRATEGY IN THIS HIGH-RISK PATIENT GROUP. 2015 16 3520 30 IGLV3-21R110 IDENTIFIES AN AGGRESSIVE BIOLOGICAL SUBTYPE OF CHRONIC LYMPHOCYTIC LEUKEMIA WITH INTERMEDIATE EPIGENETICS. B-CELL RECEPTOR (BCR) SIGNALING IS CRUCIAL FOR CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) BIOLOGY. IGLV3-21-EXPRESSING B CELLS MAY ACQUIRE A SINGLE POINT MUTATION (R110) THAT TRIGGERS AUTONOMOUS BCR SIGNALING, CONFERRING AGGRESSIVE BEHAVIOR. EPIGENETIC STUDIES HAVE DEFINED 3 CLL SUBTYPES BASED ON METHYLATION SIGNATURES REMINISCENT OF NAIVE-LIKE (N-CLL), INTERMEDIATE (I-CLL), AND MEMORY-LIKE (M-CLL) B CELLS WITH DIFFERENT BIOLOGICAL FEATURES. I-CLL CARRIES A BORDERLINE IGHV MUTATIONAL LOAD AND SIGNIFICANTLY HIGHER USE OF IGHV3-21/IGLV3-21. TO DETERMINE THE CLINICAL AND BIOLOGICAL FEATURES OF IGLV3-21R110 CLL AND ITS RELATIONSHIP TO THESE EPIGENETIC SUBTYPES, WE CHARACTERIZED THE IMMUNOGLOBULIN GENE OF 584 CLL CASES USING WHOLE-GENOME/EXOME AND RNA SEQUENCING. IGLV3-21R110 WAS DETECTED IN 6.5% OF CASES: 30 (38%) OF 79 I-CLLS, 5 (1.7%) OF 291 M-CLLS, AND 1 (0.5%) OF 189 N-CLLS. ALL STEREOTYPE SUBSET 2 CASES CARRIED IGLV3-21R110, WHEREAS 62% OF IGLV3-21R110 I-CLL CASES HAD NONSTEREOTYPED BCR IMMUNOGLOBULINS. IGLV3-21R110 I-CLL HAD A SIGNIFICANTLY HIGHER NUMBER OF SF3B1 AND ATM MUTATIONS AND TOTAL NUMBER OF DRIVER ALTERATIONS. HOWEVER, THE R110 MUTATION WAS THE SOLE ALTERATION IN 1 I-CLL AND WAS ACCOMPANIED ONLY BY DEL(13Q) IN 3. ALTHOUGH IGHV MUTATIONAL STATUS VARIED, IGLV3-21R110 I-CLL TRANSCRIPTOMICALLY RESEMBLED N-CLL/UNMUTATED IGHV CLL WITH A SPECIFIC SIGNATURE INCLUDING WNT5A/B OVEREXPRESSION. IN CONTRAST, I-CLL LACKING IGLV3-21R110 MIRRORED M-CLL/MUTATED IGHV. PATIENTS WITH IGLV3-21R110 I-CLL HAD A SHORT TIME TO FIRST TREATMENT AND OVERALL SURVIVAL SIMILAR TO THOSE OF N-CLL/UNMUTATED IGHV PATIENTS, WHEREAS PATIENTS WITH NON-IGLV3-21R110 I-CLL HAD A GOOD PROGNOSIS SIMILAR TO THAT OF PATIENTS WITH M-CLL/MUTATED IGHV. IGLV3-21R110 DEFINES A CLL SUBGROUP WITH SPECIFIC BIOLOGICAL FEATURES AND AN UNFAVORABLE PROGNOSIS INDEPENDENT OF IGHV MUTATIONAL STATUS AND EPIGENETIC SUBTYPE. 2021 17 2431 47 EPIGENETIC SILENCING OF MIR-26A1 IN CHRONIC LYMPHOCYTIC LEUKEMIA AND MANTLE CELL LYMPHOMA: IMPACT ON EZH2 EXPRESSION. DOWNREGULATION OF MIR26A1 HAS BEEN REPORTED IN VARIOUS B-CELL MALIGNANCIES; HOWEVER, THE MECHANISM BEHIND ITS DEREGULATION REMAINS LARGELY UNKNOWN. WE INVESTIGATED MIR26A1 METHYLATION AND EXPRESSION LEVELS IN A WELL-CHARACTERIZED SERIES OF CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) AND MANTLE CELL LYMPHOMA (MCL). FROM 450K METHYLATION ARRAYS, WE FIRST OBSERVED MIR26A1 (CG26054057) AS UNIFORMLY HYPERMETHYLATED IN MCL (N = 24) (ALL >75%), WHILE CLL (N = 18) SHOWED DIFFERENTIAL METHYLATION BETWEEN PROGNOSTIC SUBGROUPS. EXTENDED ANALYSIS USING PYROSEQUENCING CONFIRMED OUR FINDINGS AND REAL-TIME QUANTITATIVE PCR VERIFIED LOW MIR26A1 EXPRESSION IN BOTH CLL (N = 70) AND MCL (N = 38) COMPARED TO NORMAL B-CELLS. NOTABLY, THE LEVEL OF MIR26A1 METHYLATION PREDICTED OUTCOME IN CLL, WITH HIGHER LEVELS SEEN IN POOR-PROGNOSTIC, IGHV-UNMUTATED CLL. SINCE EZH2 WAS RECENTLY REPORTED AS A TARGET FOR MIR26A1, WE ANALYZED THE EXPRESSION LEVELS OF BOTH MIR26A1 AND EZH2 IN PRIMARY CLL SAMPLES AND OBSERVED AN INVERSE CORRELATION. BY OVEREXPRESSION OF MIR26A1 IN CLL AND MCL CELL LINES, REDUCED EZH2 PROTEIN LEVELS WERE OBSERVED USING BOTH WESTERN BLOT AND FLOW CYTOMETRY. IN CONTRAST, METHYL-INHIBITOR TREATMENT LED TO UPREGULATED MIR26A1 EXPRESSION WITH A PARALLEL DECREASE OF EZH2 EXPRESSION. FINALLY, INCREASED LEVELS OF APOPTOSIS WERE OBSERVED IN MIR26A1-OVEREXPRESSING CELL LINES, FURTHER UNDERSCORING THE FUNCTIONAL RELEVANCE OF MIR26A1. IN SUMMARY, WE PROPOSE THAT EPIGENETIC SILENCING OF MIR26A1 IS REQUIRED FOR THE MAINTENANCE OF INCREASED LEVELS OF EZH2, WHICH IN TURN TRANSLATE INTO A WORSE OUTCOME, AS SHOWN IN CLL, HIGHLIGHTING MIR26A1 AS A TUMOR SUPPRESSOR MIRNA. 2016 18 4229 26 METHYLATION OF INK4 AND CIP/KIP FAMILIES OF CYCLIN-DEPENDENT KINASE INHIBITOR IN CHRONIC LYMPHOCYTIC LEUKAEMIA IN CHINESE PATIENTS. BACKGROUND: INK4 (P15, P16, P18 AND P19) AND CIP/KIP (P21, P27 AND P57) ARE TWO FAMILIES OF CYCLIN-DEPENDENT KINASE INHIBITORS (CKI) TARGETING CDK4/6 AND CDK2, RESPECTIVELY. AIM: TO STUDY THE ROLE OF METHYLATION IN THE INACTIVATION OF CKI IN CHRONIC LYMPHOCYTIC LEUKAEMIA (CLL). MATERIALS AND METHODS: METHYLATION-SPECIFIC POLYMERASE CHAIN REACTION WAS CARRIED OUT ON DNA OBTAINED FROM THE BONE MARROW OF 56 NEWLY DIAGNOSED PATIENTS WITH CLL. RESULTS: SIMILAR DEMOGRAPHIC FEATURES AND CLINICAL OUTCOME WERE OBSERVED IN OUR PATIENTS WHEN COMPARED WITH CAUCASIAN PATIENTS, INCLUDING AN INDOLENT CLINICAL COURSE (10-YEAR OVERALL SURVIVAL 51%) AND ADVANCED RAI STAGE (P = 0.006), AND A HIGH-RISK KARYOTYPE SUCH AS TRISOMY 12 AND COMPLEX ABERRATIONS (P = 0.03). IN THE INK4 FAMILY, METHYLATION IN P15 AND P16 OCCURRED IN 20 (35.7%) AND 8 (14.3%) PATIENTS, RESPECTIVELY. IN ALL, 5 (8.9%) CLL SAMPLES HARBOURED CONCURRENT METHYLATION OF BOTH P15 AND P16. APART FROM AN ASSOCIATION OF P16 METHYLATION WITH HIGHER PRESENTING LEUCOCYTE COUNT (64.5 X 10(9)/L IN METHYLATED P16 AND 16.0 X 10(9)/L IN UNMETHYLATED P16 PATIENTS; P = 0.016), THERE WAS NO ASSOCIATION BETWEEN P15 AND P16 METHYLATION AND AGE, SEX AND RAI STAGE. NO DIFFERENCE WAS OBSERVED IN THE OVERALL SURVIVAL FOR PATIENTS WITH AND WITHOUT P15 AND P16 METHYLATION. BY CONTRAST, P18 AND RB WERE UNMETHYLATED IN ALL SAMPLES. IN THE CIP/KIP FAMILY, APART FROM INFREQUENT METHYLATION OF P57 IN 4 (7.1%) PATIENTS, METHYLATION OF P21 AND P27 WAS UNIFORMLY ABSENT. CONCLUSION: P15 AND, LESS FREQUENTLY, P16 OF THE INK4 FAMILY OF CKI, INSTEAD OF THE CIP OR KIP FAMILY, WERE TARGETED BY METHYLATION IN CLL. P16 METHYLATION WAS ASSOCIATED WITH A HIGHER LYMPHOCYTE COUNT AT PRESENTATION. THIS IS THE FIRST COMPREHENSIVE STUDY OF THE EPIGENETIC DYSREGULATION OF THE INK4 AND CIP/KIP FAMILIES OF CKI IN CHINESE PATIENTS WITH CLL. 2006 19 690 27 BRD4 DEGRADATION BLOCKS EXPRESSION OF MYC AND MULTIPLE FORMS OF STEM CELL RESISTANCE IN PH(+) CHRONIC MYELOID LEUKEMIA. IN MOST PATIENTS WITH CHRONIC MYELOID LEUKEMIA (CML) CLONAL CELLS CAN BE KEPT UNDER CONTROL BY BCR::ABL1 TYROSINE KINASE INHIBITORS (TKI). HOWEVER, OVERT RESISTANCE OR INTOLERANCE AGAINST THESE TKI MAY OCCUR. WE IDENTIFIED THE EPIGENETIC READER BRD4 AND ITS DOWNSTREAM-EFFECTOR MYC AS GROWTH REGULATORS AND THERAPEUTIC TARGETS IN CML CELLS. BRD4 AND MYC WERE FOUND TO BE EXPRESSED IN PRIMARY CML CELLS, CD34(+) /CD38(-) LEUKEMIC STEM CELLS (LSC), AND IN THE CML CELL LINES KU812, K562, KCL22, AND KCL22(T315I) . THE BRD4-TARGETING DRUG JQ1 WAS FOUND TO SUPPRESS PROLIFERATION IN KU812 CELLS AND PRIMARY LEUKEMIC CELLS IN THE MAJORITY OF PATIENTS WITH CHRONIC PHASE CML. IN THE BLAST PHASE OF CML, JQ1 WAS LESS EFFECTIVE. HOWEVER, THE BRD4 DEGRADER DBET6 WAS FOUND TO BLOCK PROLIFERATION AND/OR SURVIVAL OF PRIMARY CML CELLS IN ALL PATIENTS TESTED, INCLUDING BLAST PHASE CML AND CML CELLS EXHIBITING THE T315I VARIANT OF BCR::ABL1. MOREOVER, DBET6 WAS FOUND TO BLOCK MYC EXPRESSION AND TO SYNERGIZE WITH BCR::ABL1 TKI IN INHIBITING THE PROLIFERATION IN THE JQ1-RESISTANT CELL LINE K562. FURTHERMORE, BRD4 DEGRADATION WAS FOUND TO OVERCOME OSTEOBLAST-INDUCED TKI RESISTANCE OF CML LSC IN A CO-CULTURE SYSTEM AND TO BLOCK INTERFERON-GAMMA-INDUCED UPREGULATION OF THE CHECKPOINT ANTIGEN PD-L1 IN LSC. FINALLY, DBET6 WAS FOUND TO SUPPRESS THE IN VITRO SURVIVAL OF CML LSC AND THEIR ENGRAFTMENT IN NSG MICE. TOGETHER, TARGETING OF BRD4 AND MYC THROUGH BET DEGRADATION SENSITIZES CML CELLS AGAINST BCR::ABL1 TKI AND IS A POTENT APPROACH TO OVERCOME MULTIPLE FORMS OF DRUG RESISTANCE IN CML LSC. 2022 20 4549 21 MUTATION ANALYSIS OF THERAPY-RELATED MYELOID NEOPLASMS. WE ANALYZED THE GENETIC MUTATION STATUS OF 13 PATIENTS WITH THERAPY-RELATED MYELOID NEOPLASMS (T-MN). CONSISTENT WITH PREVIOUS REPORTS, T-MN CELLS PREFERENTIALLY ACQUIRED MUTATIONS IN TP53 AND EPIGENETIC MODIFYING GENES, INSTEAD OF MUTATIONS IN TYROSINE KINASE AND SPLICEOSOME GENES. FURTHERMORE, WE COMPARED THE MUTATION STATUS OF THREE T-MN CELLS WITH EACH OF THE INITIAL LYMPHOID MALIGNANT CELLS, AND IDENTIFIED COMMON MUTATIONS AMONG T-MN AND THE INITIAL MALIGNANT CELLS IN TWO PATIENTS. IN A PATIENT WHO DEVELOPED CHRONIC MYELOMONOCYTIC LEUKEMIA (CMML) AFTER FOLLICULAR LYMPHOMA (FL), TET2 MUTATION WAS IDENTIFIED IN BOTH CMML AND FL CELLS. NOTABLY, THE TET2 MUTATION WAS ALSO IDENTIFIED IN PERIPHERAL BLOOD CELLS IN THE DISEASE-FREE PERIOD WITH THE SAME ALLELIC FREQUENCY AS CMML AND FL CELLS, BUT NOT IN A GERM-LINE CONTROL, INDICATING THAT THE TET2 MUTATION OCCURRED SOMATICALLY IN THE INITIATING CLONE FOR BOTH MALIGNANT CELLS. ON THE OTHER HAND, A GERM-LINE MYB MUTATION WAS IDENTIFIED IN A PATIENT WHO DEVELOPED MYELODYSPLASTIC SYNDROMES (MDS) AFTER FL. THESE RESULTS SUGGEST THAT GERM-LINE DEPOSITION AND CLONAL HEMATOPOIESIS ARE CLOSELY ASSOCIATED WITH T-MN SUSCEPTIBILITY; HOWEVER, FURTHER ANALYSIS IS NECESSARY TO CLARIFY THE MECHANISM REQUIRED TO PROVIDE THE INITIATING CLONE WITH LINEAGE COMMITMENT AND CLONAL EXPANSION. 2018