Banella Cristina, Catalano Gianfranco, Calvani Maura, Candi Eleonora, Noguera Nelida Ines, Travaglini Serena
Department of Pediatric Hematology-Oncology, Meyer Children's Hospital IRCCS, 50139 Florence, Italy.
Department of Biomedicine and Prevention, Tor Vergata University, 00133 Rome, Italy.
J Pers Med. 2025 Sep 8;15(9):431. doi: 10.3390/jpm15090431.
Acute Myeloid Leukemia (AML) is a genetically and clinically heterogeneous malignancy marked by poor prognosis and limited therapeutic options, especially in older patients. While conventional treatments such as the "7 + 3" chemotherapy regimen and allogeneic stem cell transplantation remain standard care options, the advent of next-generation sequencing (NGS) has transformed our understanding of AML's molecular complexity. Among the emerging hallmarks of AML, metabolic reprogramming has gained increasing attention for its role in supporting leukemic cell proliferation, survival, and therapy resistance. Distinct AML subtypes-shaped by specific genetic alterations, including , , and mutations-exhibit unique metabolic phenotypes that reflect their underlying molecular landscapes. Notably, -ITD mutations are associated with enhanced reactive oxygen species (ROS) production and altered energy metabolism, contributing to disease aggressiveness and poor clinical outcomes. This review highlights the interplay between metabolic plasticity and genetic heterogeneity in AML, with a particular focus on FLT3-driven metabolic rewiring. We discuss recent insights into how these metabolic dependencies may be exploited therapeutically, offering a rationale for the development of metabolism-targeted strategies in the treatment of -mutated AML.
急性髓系白血病(AML)是一种在基因和临床上具有异质性的恶性肿瘤,其预后较差且治疗选择有限,在老年患者中尤为如此。虽然诸如“7 + 3”化疗方案和异基因干细胞移植等传统治疗方法仍然是标准的治疗选择,但下一代测序(NGS)的出现改变了我们对AML分子复杂性的认识。在AML新出现的特征中,代谢重编程因其在支持白血病细胞增殖、存活和治疗抗性方面的作用而受到越来越多的关注。由特定基因改变形成的不同AML亚型,包括 、 和 突变,表现出独特的代谢表型,反映了其潜在的分子格局。值得注意的是, -ITD突变与活性氧(ROS)生成增加和能量代谢改变有关,导致疾病侵袭性和不良临床结果。本综述强调了AML中代谢可塑性与基因异质性之间的相互作用,特别关注FLT3驱动的代谢重塑。我们讨论了最近关于如何在治疗上利用这些代谢依赖性的见解,为开发针对 -突变AML的代谢靶向策略提供了理论依据。