Division of Pharmaceutics and Pharmaceutical Chemistry, College of Pharmacy, The Ohio State University, Columbus, OH, 43210, USA.
Comprehensive Cancer Center, The Ohio State University, Columbus, OH, 43210, USA.
Nat Commun. 2019 May 16;10(1):2189. doi: 10.1038/s41467-019-09917-0.
Improvement in survival has been achieved for children and adolescents with AML but is largely attributed to enhanced supportive care as opposed to the development of better treatment regimens. High risk subtypes continue to have poor outcomes with event free survival rates <40% despite the use of high intensity chemotherapy in combination with hematopoietic stem cell transplant. Here we combine high-throughput screening, intracellular accumulation assays, and in vivo efficacy studies to identify therapeutic strategies for pediatric AML. We report therapeutics not currently used to treat AML, gemcitabine and cabazitaxel, have broad anti-leukemic activity across subtypes and are more effective relative to the AML standard of care, cytarabine, both in vitro and in vivo. JAK inhibitors are selective for acute megakaryoblastic leukemia and significantly prolong survival in multiple preclinical models. Our approach provides advances in the development of treatment strategies for pediatric AML.
儿童和青少年急性髓系白血病(AML)的生存率有所提高,但这主要归因于支持性治疗的加强,而不是更好的治疗方案的发展。尽管使用高强度化疗联合造血干细胞移植,但高风险亚型的无事件生存率仍<40%。在这里,我们结合高通量筛选、细胞内积累测定和体内疗效研究,确定治疗儿科 AML 的策略。我们报告了目前尚未用于治疗 AML 的治疗药物,吉西他滨和卡巴他赛,在多种亚型中具有广泛的抗白血病活性,并且相对于 AML 的标准治疗药物阿糖胞苷,无论是在体外还是体内,都更有效。JAK 抑制剂对急性巨核细胞白血病具有选择性,可显著延长多种临床前模型的生存期。我们的方法为儿科 AML 治疗策略的发展提供了进展。