Efficacy of a Novel Bcl-XL Degrader, DT2216, in Preclinical Models of JAK2-Mutated Post-MPN AML

Authors

Zhe Wang
Anna Skwarska
Gowri Poigaialwar
Sovira Chaudhry
Alba Rodriguez-Meira
Pinpin Sui
Emmanuel Olivier
Yannan Jia
Varun Gupta
Warren Fiskus
Cassandra L Ramage
Guangrong Zheng
Alexandra Schurer
Kira Gritsman
Eirini P Papapetrou
Kapil Bhalla
Daohong Zhou
Adam J Mead
Raajit K Rampal
Jeffrey W Tyner
Hussein A Abbas
Naveen Pemmaraju
Qi Zhang Tatarata
Marina Konopleva

Language

English

Publication Date

7-17-2025

Journal

Blood

DOI

10.1182/blood.2024027117

PMID

40163809

PMCID

PMC12333229

PubMedCentral® Posted Date

4-2-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Acute myeloid leukemia (AML) that evolves from myeloproliferative neoplasm (MPN) is known as post-MPN AML. Current treatments do not significantly extend survival beyond 12 months. B-cell lymphoma-extra large (BCL-xL) has been found to be overexpressed in leucocytes from patients with MPN, making it a potential therapeutic target. We investigated the role of BCL-xL in post-MPN AML and tested the efficacy of DT2216, a platelet-sparing BCL-xL proteolysis-targeting chimera, in preclinical models of post-MPN AML. We found that BCL2L1, the gene encoding BCL-xL, is expressed at higher levels in patients with post-MPN AML than in those with de novo AML. Single-cell multiomics analysis revealed that leukemia cells harboring both MPN-driver and TP53 mutations exhibited higher BCL2L1 expression and elevated scores for leukemia stem cell, megakaryocyte development, and erythroid progenitor than wild-type cells. BH3 profiling confirmed a strong dependence on BCL-xL in post-MPN AML cells. DT2216 alone, or in combination with standard AML/MPN therapies, effectively degraded BCL-xL, reduced the apoptotic threshold, and induced apoptosis in post-MPN AML cells. DT2216 effectively eliminated viable cells in JAK2-mutant AML cell lines, induced pluripotent stem cell–derived hematopoietic progenitor cells, primary samples, and reduced tumor burden in cell line–derived xenograft model in vivo by degrading BCL-xL. DT2216, either as a single agent or in combination with azacytidine, effectively inhibited the clonogenic potential of CD34+ leukemia cells from patients with post-MPN AML. In summary, our data indicate that the survival of post-MPN AML is BCL-xL dependent, and DT2216 may offer therapeutic advantage in this high-risk leukemia subset with limited treatment options.

Keywords

bcl-X Protein, Humans, Leukemia, Myeloid, Acute, Animals, Mice, Janus Kinase 2, Myeloproliferative Disorders, Mutation, Xenograft Model Antitumor Assays, Apoptosis, Proteolysis, Female

Published Open-Access

yes

Recommended Citation

Wang, Zhe; Skwarska, Anna; Poigaialwar, Gowri; et al., "Efficacy of a Novel Bcl-XL Degrader, DT2216, in Preclinical Models of JAK2-Mutated Post-MPN AML" (2025). Faculty, Staff and Student Publications. 5227.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5227