A new study shows how a single gene could be at fault in acute myeloid leukemia (AML), one of the deadliest cancers.
Researchers say the breakthrough could eventually lead to gene-targeted therapy that could improve AML survival rates, which have not budged in recent years.
The gene, known as EVI1, rewires the entire panoply of blood-forming cells and tissues by binding to certain DNA molecules and wreaking havoc. Knowing where EVI1 locks into the genome helps scientists understand the mechanisms that drive the disease at its core.
Now, researchers say they can envision a new approach to treating AML, focused on blocking EVI1’s ability to bind to other genes, according to the study, which appears in Nature Communications.
“It’s not so pie-in-the-sky anymore to think we can interrupt the process within the genome that leads to leukemia.”
“It’s not so pie-in-the-sky anymore to think we can interrupt the process within the genome that leads to leukemia,” says senior author Archibald Perkins, professor of pathology and laboratory medicine at the University of Rochester Medical Center.
Thanks to immunotherapy and other targeted approaches, treatments for many types of blood cancers have improved greatly but patients with AML have not benefited as much—the disease’s five-year survival rate remains at around 25 percent. Although some leukemia patients can achieve a lasting remission with a blood and marrow transplant, the disease almost always relapses.
Scientists worldwide have been studying the gene EVI1 for years, looking at its relationship to leukemia from different angles with the goal of finding a new treatment.
Study coauthors Laura Calvi and James Palis contributed to the latest insights by offering new perspectives on the hematopoietic system, Perkins says. They study the cells, organs, and tissues involved in blood production and the factors that may impact cancer development.
EVI1 is at the center of the investigation because when it’s over-expressed—producing 10,000 to 50,000 copies compared to the low levels seen in healthy people—it changes the metabolism of immature blood cells as they become malignant. Working together, the researchers discovered the importance of what happens after EVI1 is overexpressed and turned on permanently.
The study is believed to be a first in a few ways, Perkins says:
- It shows in explicit detail how disruption to the blood system leads to an expansion of myeloid cells—crowding out the healthy blood cells that carry oxygen and fight infection. Myeloid cells eventually nurture leukemia production in the bone marrow.
- It uses a mouse model that closely mimics the human experience with AML. The disease usually occurs later in adulthood after a rearrangement of chromosomes at 3q26, due to DNA damage.
- It documents how and where the single gene in question, EVI1, binds to certain DNA molecules and begins causing problems. Spotlighting this action helps scientists to learn where the disease is targetable.
Additional coauthors are from the University of Rochester Medical Center. The National Institutes of Health, New York State Stem Cell Science, the Wilmot Cancer Institute, and the Clinical and Translational Science Institute at the University of Rochester funded the work.
Source: University of Rochester