J Korean Med Sci.  2021 Apr;36(13):e85. 10.3346/jkms.2021.36.e85.

Recent Clinical Update of Acute Myeloid Leukemia: Focus on Epigenetic Therapies

• Lee E
• Koh Y
• Hong J
• Eom HS
• Yoon SS

• KMID: 2514759
• DOI: http://doi.org/10.3346/jkms.2021.36.e85

Abstract

Acute myeloid leukemia (AML) is a complicated disease characterized by genetic heterogeneity and simultaneous alterations in multiple genes. For decades, its only curative method has been intensive induction chemotherapy with or without allogeneic hematopoietic stem cell transplantation, and this approach cannot be applied to elderly patients, who make up more than 50% of AML patients. Recent advances in genomics facilitated the elucidation of various mutations related to AML, and the most frequent mutations were discovered in epigenetic regulators. Alterations to epigenetic modifications that are essential for normal cell biology, including DNA methylation and histone acetylation, have been identified. As epigenetic dysregulation is an important carcinogenic mechanism and some epigenetic changes are reversible, these epigenetic alterations have become targets for novel drug development against AML. This review summarizes the recent advances in epigenetic therapies for AML and discusses future research directions.

Keyword

Acute Myeloid Leukemia; Epigenetic Therapy

Figure

• 

  Fig. 1 Overview of epigenetic mechanisms and targeting agents.HDAC = histone deacetylase, EZH = enhancer of zeste 2 polycomb repressive complex, LSD = lysine demethylase, MLL = myeloid/lymphoid or mixed-lineage leukemia, DOT1L = DOT1 like histone lysine methyltransferase, HMA = hypomethylating agent, DNMT = DNA methyltransferase, IDH = isocitrate dehydrogenase.

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