Isocitrate dehydrogenase 1 mutations prime the all-trans retinoic acid myeloid differentiation pathway in acute myeloid leukemia

authors

• Boutzen Héléna
• Saland Estelle
• Larrue Clément
• de Toni Fabienne
• Gales Lara
• Castelli Florence
• Cathebas Mathilde
• Zaghdoudi Sonia
• Stuani Lucille
• Kaoma Tony
• Riscal Romain
• Yang Guangli
• Hirsch Pierre
• David Marion
• de Mas-Mansat Véronique
• Delabesse Eric
• Vallar Laurent
• Delhommeau François
• Jouanin Isabelle
• Ouerfelli Ouathek
• Le Cam Laurent
• Linares Laetitia K.
• Junot Christophe
• Portais Jean-Charles
• Vergez François
• Recher Christian
• Sarry Jean-Emmanuel

keywords

• Α-KG
• Abbreviations u
• 2-hydroxyglutar
• Α-ketoglutarate
• AML
• Acute myeloid l
• APL
• Acute PML
• ATRA
• All-trans RA
• BCL
• B cell lymphoma
• ChIP
• Chromatin immun
• GSEA
• Gene set enrich
• IDH
• Isocitrate de-
• L-CFU
• Leukemic CFU
• LC/MS
• Liquid chromato
• NBT
• Nitrotetrazoliu
• PML
• Promyelocytic l
• QChIP
• Quantitative Ch
• QPCR
• Quantitative PC
• RA
• Retinoic acid
• TF
• Transcription f

abstract

Acute myeloid leukemia (AML) is characterized by the accumulation of malignant blasts with impaired differentiation programs caused by recurrent mutations, such as the isocitrate dehydrogenase (IDH) mutations found in 15% of AML patients. These mutations result in the production of the oncometabolite (R)-2-hydroxyglutarate (2-HG), leading to a hypermethylation phenotype that dysregulates hematopoietic differentiation. In this study, we identified mutant R132H IDH1-specific gene signatures regulated by key transcription factors, particularly CEBPα, involved in myeloid differentiation and retinoid responsiveness. We show that treatment with all-trans retinoic acid (ATRA) at clinically achievable doses markedly enhanced terminal granulocytic differentiation in AML cell lines, primary patient samples, and a xenograft mouse model carrying mutant IDH1. Moreover, treatment with a cell-permeable form of 2-HG sensitized wild-type IDH1 AML cells to ATRA-induced myeloid differentiation, whereas inhibition of 2-HG production significantly reduced ATRA effects in mutant IDH1 cells. ATRA treatment specifically decreased cell viability and induced apoptosis of mutant IDH1 blasts in vitro. ATRA also reduced tumor burden of mutant IDH1 AML cells xenografted in NOD-Scid-IL2rγ(null)mice and markedly increased overall survival, revealing a potent antileukemic effect of ATRA in the presence of IDH1 mutation. This therapeutic strategy holds promise for this AML patient subgroup in future clinical studies.

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