Chromatin Profiles Are Prognostic of Clinical Response to Bortezomib-Containing Chemotherapy in Pediatric Acute Myeloid Leukemia: Results from the COG AAML1031 Trial

Authors

Anneke D van Dijk
Fieke W Hoff
Yihua Qiu
Stefan E Hubner
Robin L Go
Vivian R Ruvolo
Amanda R Leonti
Robert B Gerbing
Alan S Gamis
Richard Aplenc
Edward A Kolb
Todd A Alonzo
Soheil Meshinchi
Eveline S J M de Bont
Terzah M Horton
Steven M Kornblau

Publication Date

4-9-2024

Journal

Cancers

Abstract

The addition of the proteasome inhibitor bortezomib to standard chemotherapy did not improve survival in pediatric acute myeloid leukemia (AML) when all patients were analyzed as a group in the Children's Oncology Group phase 3 trial AAML1031 (NCT01371981). Proteasome inhibition influences the chromatin landscape and proteostasis, and we hypothesized that baseline proteomic analysis of histone- and chromatin-modifying enzymes (HMEs) would identify AML subgroups that benefitted from bortezomib addition. A proteomic profile of 483 patients treated with AAML1031 chemotherapy was generated using a reverse-phase protein array. A relatively high expression of 16 HME was associated with lower EFS and higher 3-year relapse risk after AML standard treatment compared to low expressions (52% vs. 29%, p = 0.005). The high-HME profile correlated with more transposase-accessible chromatin, as demonstrated via ATAC-sequencing, and the bortezomib addition improved the 3-year overall survival compared with standard therapy (62% vs. 75%, p = 0.033). These data suggest that there are pediatric AML populations that respond well to bortezomib-containing chemotherapy.

Keywords

pediatric acute myeloid leukemia, reverse-phase protein array, bortezomib

Comments

Supplementary Materials

PMID: 38672531