Feasible Diet and Circadian Interventions Reduce In Vivo Progression of FLT3-ITD-Positive Acute Myeloid Leukemia

Authors

Megan Rodriguez
Baharan Fekry
Brianna Murphy
Mary Figueroa
Tiewei Cheng
Margaret Raber
Lisa Wartenberg
Donna Bell
Lisa Triche
Karla Crawford
Huaxian Ma
Kendra Allton
Ruwaida Ahmed
Jaime Tran
Christine Ranieri
Marina Konopleva
Michelle Barton
Cesar Nunez
Kristin Eckel-Mahan
Joya Chandra

Publication Date

1-1-2024

Journal

Cancer Medicine

Abstract

BACKGROUND: Acute myeloid leukemia (AML) with an internal tandem duplication in the fms-like tyrosine kinase receptor 3 gene (FLT3-ITD) is associated with poor survival, and few studies have examined the impact of modifiable behaviors, such as nutrient quality and timing, in this subset of acute leukemia.

METHODS: The influence of diet composition (low-sucrose and/or low-fat diets) and timing of diet were tested in tandem with anthracycline treatment in orthotopic xenograft mouse models. A pilot clinical study to test receptivity of pediatric leukemia patients to macronutrient matched foods was conducted. A role for the circadian protein, BMAL1 (brain and muscle ARNT-like 1), in effects of diet timing was studied by overexpression in FLT3-ITD-bearing AML cells.

RESULTS: Reduced tumor burden in FLT3-ITD AML-bearing mice was observed with interventions utilizing low-sucrose and/or low-fat diets, or time-restricted feeding (TRF) compared to mice fed normal chow ad libitum. In a tasting study, macronutrient matched low-sucrose and low-fat meals were offered to pediatric acute leukemia patients who largely reported liking the meals. Expression of the circadian protein, BMAL1, was heightened with TRF and the low-sucrose diet. BMAL1 overexpression and treatment with a pharmacological inducer of BMAL1 was cytotoxic to FLT3-ITD AML cells.

CONCLUSIONS: Mouse models for FLT3-ITD AML show that diet composition and timing slows progression of FLT3-ITD AML growth in vivo, potentially mediated by BMAL1. These interventions to enhance therapy efficacy show preliminary feasibility, as pediatric leukemia patients responded favorable to preparation of macronutrient matched meals.

Keywords

Humans, Child, Mice, Animals, ARNTL Transcription Factors, Leukemia, Myeloid, Acute, Antineoplastic Agents, Disease Models, Animal, Diet, Sucrose, fms-Like Tyrosine Kinase 3, Mutation, acute myeloid leukemia, circadian rhythm, diet, time‐restricted feeding

Comments

PMID: 38334474