Leukemia最新文献

{"title":"Aberrant splicing of CHEK1 is a driver of megakaryocytic dysplasia in U2AF1S34F mutant myelodysplastic neoplasms","authors":"Wenjun Zhang, Bing Li, Jinqin Liu, Yiru Yan, Lin Yang, Tiejun Qin, Zefeng Xu, Qi Sun, Yujiao Jia, Huijun Wang, Gang Huang, Hongtao Wang, Lihong Shi, Jiaxi Zhou, Zhijian Xiao","doi":"10.1038/s41375-025-02684-6","DOIUrl":"10.1038/s41375-025-02684-6","url":null,"abstract":"U2AF1 mutations are common in patients with myelodysplastic neoplasms (MDS), suggesting that aberrant splicing of pre-mRNAs driven by mutant U2AF1 could play a critical role in MDS pathogenesis. Previous studies have demonstrated that U2AF1S34F mutation impairs the differentiation of erythrocytes and granulocytes, but the impact on megakaryocytes (MKs) remains unclear. Here, by integrating data from MDS patients and cell lines with U2AF1 mutations, we determined that U2AF1 mutations are associated with dysmegakaryopoiesis, induce the generation of abnormal MKs, especially micro-MKs, and induce significant thrombocytopenia. We determined that mutant U2AF1-mediated aberrant splicing of DNA biosynthesis-related genes, such as CHEK1, is required for normal MK polyploidization. The mis-splicing of CHEK1, in turn, accounts for the increased number of abnormal MKs in U2AF1-mutant MDS patients. Moreover, U2AF1S34 mutations induce the deficiency of CHK1 and the activation of its phosphorylation, thereby further driving the impairment of MK polyploidization and maturation. Accordingly, treatment with selective CHK1 inhibitor significantly reduces abnormal MK production in vitro. Taken together, these findings demonstrate that U2AF1 mutations induce the generation of abnormal MKs by driving aberrant splicing of the CHEK1 cell cycle-related gene, revealing the molecular basis for dysmegakaryopoiesis in MDS and identifying a new potential target for MDS treatment.","PeriodicalId":18109,"journal":{"name":"Leukemia","volume":"39 9","pages":"2246-2255"},"PeriodicalIF":13.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rituximab, high-dose methotrexate plus orelabrutinib as induction therapy in newly diagnosed primary central nervous system lymphoma","authors":"Shi-Hua Zhao, Zun-Min Zhu, Tao Yang, Da Gao, Li-Hong Liu, Wei Yang, Xiao-Bo Wang, Yu-Xia Zhao, Meng Li, Yi-Nan Gao, Rong-Jun Ma, Ying Yang, Hui-Ping Li, Li Li, Xiao-Lei Ao, Xiu-Bin Xiao, Chong-Ling Hu, Shun-Zong Yuan, Yao Ding, Xi-Lin Chen, Jian-Xia He, Yao Liu, Wen-Rong Huang","doi":"10.1038/s41375-025-02658-8","DOIUrl":"10.1038/s41375-025-02658-8","url":null,"abstract":"","PeriodicalId":18109,"journal":{"name":"Leukemia","volume":"39 8","pages":"2035-2038"},"PeriodicalIF":13.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41375-025-02658-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ontogeny-specific induction of the KMT2A::AFF1-fusion drives development of a distinct CD24 positive pre-leukemic state","authors":"Ariana S. Calderón, Roshanak Ghazanfari, Zahra Masoumi, Shabnam Kharazi, Sara Palo, Stefan Lang, Kristijonas Žemaitis, Mohamed Eldeeb, Agatheeswaran Subramaniam, Shamit Soneji, Ronald W. Stam, David Bryder, Charlotta Böiers","doi":"10.1038/s41375-025-02665-9","DOIUrl":"10.1038/s41375-025-02665-9","url":null,"abstract":"Infant Acute Lymphoblastic Leukemia (ALL) driven by the KMT2A::AFF1 onco-fusion is an aggressive, poor prognosis disease with few co-operative mutations. The fusion originates in utero, yet the embryonic initiating steps of disease development remain poorly understood. Here, we present a novel murine KMT2A::AFF1 model, that provides key insights into KMT2A::AFF1 pre-leukemia, relevant to human disease. The model enables precise oncogene induction, and upon targeting hematopoietic stem and progenitor cells (HSPCs) a selective negative impact on proliferation of hematopoietic stem cells (HSCs) was observed, regardless of developmental state during induction. However, a unique CD24+PreProB subset expanded exclusively within the KMT2A::AFF1 embryonic context. This population was absent when targeting lymphoid progenitors, highlighting the importance of the cell of origin for leukemic development. The CD24+PreProB subset displayed key features of pre-leukemic stem cells, including lineage plasticity and aberrant engraftment ability. In line with their pre-malignant phenotype, single-cell transcriptomics revealed a signature consistent with stemness, and notable, up-regulation of Hmga2, a regulator of self-renewal. The signature was critically transferable to human KMT2A::AFF1 patients. Furthermore, given that CD24 is a potential therapeutic target, our findings uncover a distinct embryonic pre-leukemic state with direct relevance to human disease.","PeriodicalId":18109,"journal":{"name":"Leukemia","volume":"39 9","pages":"2099-2111"},"PeriodicalIF":13.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41375-025-02665-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interleukin-6 is a highly prognostic biomarker for POEMS syndrome","authors":"Joselle Cook, Rahma Warsame, Maryam Omar, Francis K. Buadi, Nadine Abdallah, David Dingli, Suzanne R. Hayman, Prashant Kapoor, Taxiarchis Kourelis, Moritz Binder, Eli Muchtar, Amie Fonder, Yi L. Hwa, Miriam A. Hobbs, Yi Lin, Wilson I. Gonsalves, Morie A. Gertz, Shaji K. Kumar, S. Vincent Rajkumar, Angela Dispenzieri","doi":"10.1038/s41375-025-02659-7","DOIUrl":"10.1038/s41375-025-02659-7","url":null,"abstract":"","PeriodicalId":18109,"journal":{"name":"Leukemia","volume":"39 9","pages":"2281-2284"},"PeriodicalIF":13.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41375-025-02659-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A genome-wide association study identifies an African-specific locus on chromosome 21q22.12 associated with Burkitt lymphoma risk and survival","authors":"Diptavo Dutta, Mateus H. Gouveia, Bryan R. Gorman, Atuahene Adu-Gyamfi, Chia-Han Lee, Martin D. Ogwang, Patrick Kerchan, Steven J. Reynolds, Constance N. Tenge, Pamela A. Were, Walter N. Wekesa, Robert K. Tenge, Nestory Masalu, Esther L. Kawira, Tobias Kinyera, Isaac Otim, Hadijah Nabalende, Herry Dhudha, Bosco Candia, Janet Abaru, Wusheng Yan, Oscar Florez-Vargas, Yi Xie, Michelle Ho, Leona W. Ayers, Kishor Bhatia, James J. Goedert, Ruth M. Pfeiffer, Michelle Manning, Amy Hutchinson, Nathan Cole, Wen Luo, Belynda Hicks, George Chagaluka, W. Thomas Johnston, Nora Mutalima, Eric Borgstein, George N. Liomba, Steven Kamiza, Nyengo Mkandawire, Elizabeth M. Molyneux, Collins Mitambo, Robert Newton, Reiner Siebert, Michael Dean, Meredith Yeager, Stephen J. Chanock, Ludmila Prokunina-Olsson, Sam M. Mbulaiteye","doi":"10.1038/s41375-025-02690-8","DOIUrl":"10.1038/s41375-025-02690-8","url":null,"abstract":"Burkitt lymphoma (BL) is a B-cell malignancy that disproportionately affects children in sub-Saharan Africa. We performed a genome-wide association study (GWAS) in a combined set of 800 childhood cases and 3865 controls in East Africa, controlling for age, sex, country, population-specific principal components, and a genetic relationship matrix. This analysis identified a BL-protective region within chromosome 21q22.12 tagged by the rs111457485-T allele (odds ratio [OR] = 0.57; p = 5.7 × 10−9). The results were robust in standard meta-analysis (OR = 0.57, p < 1.6 × 10−8), sensitivity analyses (removing genomic outliers and related individuals), and after adjustment for Epstein-Barr virus (EBV) status. Genomic analyses revealed long-range (over ~700 kb) chromatin interactions between the chr21q22.12 locus and the RUNX1-P1 promoter region. The African-specific rs2242780-C allele (r2 = 0.69 with the rs111457485-T allele in the study controls) showed increased enhancer activity in in-vitro Luciferase reporter assays (p = 4.5 × 10−10), nominating it as the likely functional variant for the BL-associated loci. In addition to the association with reduced BL risk in GWAS (OR = 0.62, p = 2.24 × 10−8), the rs2242780-C allele was also associated with better survival in patients with abdominal-only BL in exploratory analyses (hazard ratio = 0.39, p = 0.038, 106 patients, 59 deaths). Our GWAS uncovered novel BL-protective loci near RUNX1, offering insights into the genetic etiology of BL in African children.","PeriodicalId":18109,"journal":{"name":"Leukemia","volume":"39 9","pages":"2196-2206"},"PeriodicalIF":13.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41375-025-02690-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 European LeukemiaNet recommendations for the management of chronic myeloid leukemia","authors":"Jane F. Apperley, Dragana Milojkovic, Nicholas C. P. Cross, Henrik Hjorth-Hansen, Andreas Hochhaus, Hagop Kantarjian, Jeffrey H. Lipton, Hemant Malhotra, Dietger Niederwieser, Jerald Radich, Philippe Rousselot, Susanne Saussele, Charles A. Schiffer, Richard Silver, Simona Soverini, Leif Stenke, Anna Turkina, Luis Felipe Casado, Fausto Castagnetti, Francisco Cervantes, Richard E. Clark, Jorge Cortes, Michael Deininger, Timothy P. Hughes, Jeroen Janssen, Qian Jiang, Dong-Wook Kim, Richard A. Larson, Francois X. Mahon, Michael Mauro, Jiri Mayer, Franck E. Nicolini, Fabrizio Pane, Delphine Rea, Johan Richter, Gianantonio Rosti, Giuseppe Saglio, Rüdiger Hehlmann","doi":"10.1038/s41375-025-02664-w","DOIUrl":"10.1038/s41375-025-02664-w","url":null,"abstract":"In this 5th version of the European LeukemiaNet guidance for adult patients, there are important changes in several areas of management based on evidence available since 2020, including the World Health Organisation’s reclassification of CML as a biphasic disease. Previous advice to switch the tyrosine kinase inhibitor (TKI) on failure of molecular milestones, is modified to better account for individual patient circumstances. Our recommendations are summarized in tables designed to be read in conjunction with the text which offers justification and additional advice. We describe decision-making for first-line treatment, both in available drugs and their initial dosing. Similarly we elaborate on dose reduction rather than drug switching to manage toxicities and discuss treatment sequencing. Data have matured for the outcome of treatment discontinuation and for management of parenting for both men and women. We acknowledge that most patients will remain on treatment for many years and emphasize the needs to minimize side effects, manage co-morbidities and optimize quality of life. Recent advances in allogeneic stem cell transplantation have broadened access to alternative donors, and lessened limitations of age and co-morbidities such that transplant remains a valuable option for patients for whom long-term disease control is not achieved through TKI therapy.","PeriodicalId":18109,"journal":{"name":"Leukemia","volume":"39 8","pages":"1797-1813"},"PeriodicalIF":13.4,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41375-025-02664-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ADH5/ALDH2 dehydrogenases and DNA polymerase theta protect normal and malignant hematopoietic cells from formaldehyde challenge: therapeutic implications","authors":"Jessica Atkins, Anna-Mariya Kukuyan, Monika Toma, Malgorzata Drzewiecka, Umeshkumar Vekariya, Adam Karami, Margaret Nieborowska-Skorska, Reza Nejati, Emir Hadzijusufovic, Peter Valent, Tomasz Stoklosa, Tomasz Sliwinski, Mariusz Wasik, Tomasz Skorski","doi":"10.1038/s41375-025-02687-3","DOIUrl":"10.1038/s41375-025-02687-3","url":null,"abstract":"Normal hematopoietic stem and progenitor cells (HSPCs) are exposed to physiological levels of formaldehyde but occasionally may be challenged by high levels of formaldehyde generated by endogenous and exogenous sources. In addition, leukemia cells stressed by oncogenic mutations continuously produce excessive amounts of formaldehyde. Here, we show that DNA polymerase theta (Polθ) cooperates with alcohol dehydrogenase 5 (ADH5) and aldehyde dehydrogenase 2 (ALDH2) to protect healthy and malignant HSPCs challenged by formaldehyde. ADH5 and ALDH2 metabolize formaldehyde while Polθ-mediated DNA repair by microhomology-dependent end-joining (TMEJ) protects cells from the lethal effect of DNA double strand breaks resulting from formaldehyde-mediated DNA-protein crosslinks. Genetic or pharmacological targeting of ADH5 or ALDH2 enhanced the effect of Polθ inhibitors in leukemic cells. Thus, ADH5/ALDH2 cooperate with Polθ to protect normal HSPCs sporadically challenged by high levels of formaldehyde, and inhibition of Polθ and ADH5 or ALDH2 may exert an anti-leukemic effect.","PeriodicalId":18109,"journal":{"name":"Leukemia","volume":"39 9","pages":"2152-2162"},"PeriodicalIF":13.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41375-025-02687-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic determinants of therapy response in ETV6::RUNX1 leukemia","authors":"Laura Oksa, Sanni Moisio, Khurram Maqbool, Roger Kramer, Atte Nikkilä, Buddika Jayasingha, Artturi Mäkinen, Hassan Foroughi-Asl, Samuli Rounioja, Janne Suhonen, Olga Krali, Miikka Voutilainen, Mari Lahnalampi, Kaisa Vepsäläinen, Sui Huang, Jesus Duque-Afonso, Julia Hauer, Jessica Nordlund, Valtteri Wirta, Olli Lohi, Merja Heinäniemi","doi":"10.1038/s41375-025-02683-7","DOIUrl":"10.1038/s41375-025-02683-7","url":null,"abstract":"ETV6::RUNX1 leukemia is the second most common subtype of childhood B cell acute lymphoblastic leukemia (B-ALL). Although it generally has a low relapse risk, a significant proportion of B-ALL relapses occur within this subtype due to its relatively high incidence. Measurable residual disease at the end of induction therapy is a well-established biomarker predicting treatment outcomes, while no genomic biomarkers are routinely applied in clinics. In this study, we used multiomic data from ETV6::RUNX1 leukemias to identify genomic features predictive of therapy response at disease presentation. In the deeply characterized sub-cohort we discovered that fast-responding cases frequently exhibited the APOBEC mutational signature and the gene expression signature of high cell cycle activity. In contrast, rearrangements of IGK genes were more frequent in slow responders. Additionally, response-related mutations were identified in transcriptional regulators and tumor suppressor genes (INTS1, NF1, TP53). Copy number analysis revealed that fast responders harbored more frequent deletions of chr12 p-arm, leading to transcriptomic changes affecting genes associated with induction therapy response (KRAS, FKBP4), while a shorter gain in chr12 was more common in slow responders. The identified genetic and transcriptomic markers of treatment sensitivity pave the way for improved disease classification at presentation, potentially improving clinical outcomes.","PeriodicalId":18109,"journal":{"name":"Leukemia","volume":"39 9","pages":"2125-2139"},"PeriodicalIF":13.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41375-025-02683-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The hallmarks of hematopoietic stem cell transplantation for pediatric acute myeloid leukemia","authors":"Eva Rettinger, Dirk Heckl, Brenda Gibson, Martin Sauer, Dominik Turkiewicz, Katharina Kleinschmidt, Krzysztof Kalwak, Dirk Reinhardt, Franco Locatelli, Jan-Henning Klusmann, the Pediatric Diseases Working Party of the European Society for Blood and Marrow Transplantation","doi":"10.1038/s41375-025-02685-5","DOIUrl":"10.1038/s41375-025-02685-5","url":null,"abstract":"Allogeneic hematopoietic stem cell transplantation (HSCT) has significantly improved the outcome of children with high-risk (HR) acute myeloid leukemia (AML). Implementing allogeneic HSCT depends on numerous factors, including adverse cytogenetics, molecular abnormalities, poor response to first-line treatment, or relapsed or primary refractory disease. In HR AML, allogeneic HSCT is considered to be the consolidation strategy of choice in first complete remission (CR1) and offers the best chance of cure for patients with relapsed disease. Advances in donor/recipient typing, conditioning regimens, graft-versus-host-disease (GvHD) management, and supportive care have contributed to this improvement in overall—and transplant—outcome. This review will comprehensively discuss indications for HSCT and its modalities in pediatric AML by examining past, current, and future strategies for disease- and response-related stratification. We will examine the key importance of low/negative measurable residual disease (MRD) before transplantation and discuss conditioning regimens and graft variables, as well as novel approaches to harness the graft-versus-leukemia (GvL) effect, including targeted immunotherapy. The review will also address toxicities associated with HSCT, GvHD prophylaxis, and the management of treatment failure. Ultimately, this review seeks to inform clinical practice and highlights how improved outcomes have been achieved through the collective efforts of international study groups.","PeriodicalId":18109,"journal":{"name":"Leukemia","volume":"39 10","pages":"2313-2328"},"PeriodicalIF":13.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41375-025-02685-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemoresistance of TP53 mutant acute myeloid leukemia requires the mevalonate byproduct, geranylgeranyl pyrophosphate, for induction of an adaptive stress response","authors":"Sarah J. Skuli, A’ishah Bakayoko, Marisa Kruidenier, Bryan Manning, Paige Pammer, Akmal Salimov, Owen Riley, Gisela Brake-Sillá, Derrick Dopkin, Michael Bowman, Leslie N. Martinez-Gutierrez, Colin C. Anderson, Julie A. Reisz, Roberta Buono, Madhuri Paul, Estelle Saland, Francesca Liccardo, Ann DeVine, Sarah Wong, Jimmy P. Xu, Eva Nee, Ryan Hausler, Steffen Boettcher, Said M. Sebti, Catherine Lai, Kara N. Maxwell, Jean-Emmanuel Sarry, David A. Fruman, Angelo D’Alessandro, Clementina Mesaros, Brian Keith, M. Celeste Simon, Pamela J. Sung, Gerald Wertheim, Nicolas Skuli, Robert L. Bowman, Andrew Matthews, Martin Carroll","doi":"10.1038/s41375-025-02668-6","DOIUrl":"10.1038/s41375-025-02668-6","url":null,"abstract":"Acute myeloid leukemia with mutations in TP53 (TP53mut AML) is fatal with a median survival of 6 months. RNA sequencing on purified AML patient samples showed that TP53mut AML had higher expression of mevalonate pathway genes. Using novel, isogenic TP53mut AML cell lines and primary samples, we determined that TP53mut AML resistance to AML chemotherapy cytarabine (AraC) correlated with increased mevalonate pathway activity, a lower induction of reactive oxygen species (ROS), and a mitochondrial response with increased mitochondrial mass and oxidative phosphorylation. Pretreatment with the statin class of mevalonate pathway inhibitors reversed these effects and chemosensitized TP53mut AML. The geranylgeranyl pyrophosphate (GGPP) branch of the mevalonate pathway was required for TP53mut AML chemoresistance. In addition to its role in mitochondria biogenesis, we identified a novel function of GGPP in regulating glutathione for management of AraC-induced ROS. However, statins alone were inadequate to fully reverse chemoresistance in vivo and in a retrospective study of 364 TP53mut AML patients who received chemotherapy concurrently with a statin. Finally, we identified clinical settings and strategies to successfully target the mevalonate pathway, particularly to address the unmet need of TP53mut AML.","PeriodicalId":18109,"journal":{"name":"Leukemia","volume":"39 9","pages":"2087-2098"},"PeriodicalIF":13.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41375-025-02668-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}