AML1/ETO cooperates with HIF1α to promote leukemogenesis through DNMT3a transactivation

X. N. Gao, Fei Yan, J. Lin, L. Gao, X. L. Lu, S. C. Wei, N. Shen, J. X. Pang, Q. Y. Ning, Y. Komeno, A. L. Deng, Y. H. Xu, J. L. Shi, Y. H. Li, D. E. Zhang, C. Nervi, Shujun Liu, L. Yu

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61 Scopus citations


The mechanisms by which AML1/ETO (A/E) fusion protein induces leukemogenesis in acute myeloid leukemia (AML) without mutagenic events remain elusive. Here we show that interactions between A/E and hypoxia-inducible factor 1α (HIF1α) are sufficient to prime leukemia cells for subsequent aggressive growth. In agreement with this, HIF1α is highly expressed in A/E-positive AML patients and strongly predicts inferior outcomes, regardless of gene mutations. Co-expression of A/E and HIF1α in leukemia cells causes a higher cell proliferation rate in vitro and more serious leukemic status in mice. Mechanistically, A/E and HIF1α form a positive regulatory circuit and cooperate to transactivate DNMT3a gene leading to DNA hypermethylation. Pharmacological or genetic interventions in the A/E-HIF1α loop results in DNA hypomethylation, a re-expression of hypermethylated tumor-suppressor p15 INK4b and the blockage of leukemia growth. Thus high HIF1α expression serves as a reliable marker, which identifies patients with a poor prognosis in an otherwise prognostically favorable AML group and represents an innovative therapeutic target in high-risk A/E-driven leukemia.

Original languageEnglish (US)
Pages (from-to)1730-1740
Number of pages11
Issue number8
StatePublished - Aug 7 2015

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