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Blood, 11 June 2009, Vol. 113, No. 24, pp. 6193-6205.
Prepublished online as a Blood First Edition Paper on April 17, 2009; DOI 10.1182/blood-2008-07-166090.


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Submitted July 8, 2008
Accepted March 28, 2009

Identification of AML1-ETO modulators by chemical genomics

Steven M. Corsello, Giovanni Roti, Kenneth N. Ross, Kwan T. Chow, Ilene Galinsky, Daniel J. DeAngelo, Richard M. Stone, Andrew L. Kung, Todd R. Golub, and Kimberly Stegmaier*

Department of Pediatric Oncology, Dana-Farber Cancer Institute and Children's Hospital Boston, Harvard Medical School, Boston, MA, United States
The Broad Institute of Harvard University and Massachusetts Institute of Technology, Cambridge, MA, United States
Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States
Howard Hughes Medical Institute, Boston, MA, United States

* Corresponding author; email: kimberly_stegmaier{at}dfci.harvard.edu.

Somatic rearrangements of transcription factors are common abnormalities in the acute leukemias. With rare exception, however, the resultant protein products have remained largely intractable as pharmacological targets. One example is AML1-ETO, the most common translocation reported in AML. In order to identify AML1-ETO modulators, we screened a small molecule library using a chemical genomic approach. Gene expression signatures were used as surrogates for the expression versus loss of the translocation in AML1-ETO-expressing cells. The top classes of compounds that scored in this screen were corticosteroids and dihydrofolate reductase (DHFR) inhibitors. In addition to modulating the AML1-ETO signature, both classes induced evidence of differentiation, dramatically inhibited cell viability, and ultimately induced apoptosis via on-target activity. Furthermore, AML1-ETO-expressing cell lines were exquisitely sensitive to the effects of corticosteroids on cellular viability compared to non-expressers. The corticosteroids diminished AML1-ETO protein in AML cells in a proteasome- and glucocorticoid receptor-dependent manner. Moreover, these molecule classes demonstrated synergy in combination with standard AML chemotherapy agents and activity in an orthotopic model of AML1-ETO-positive AML. This work suggests a role for DHFR inhibitors and corticosteroids in treating patients with AML1-ETO-positive disease.


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