DNMT3A mutations promote anthracycline resistance in acute myeloid leukemia via impaired nucleosome remodeling
Open accessAbstract
Although the majority of patients with acute myeloid leukemia (AML) initially respond to chemotherapy, many of them subsequently relapse, and the mechanistic basis for AML persistence following chemotherapy has not been determined. Recurrent somatic mutations in DNA methyltransferase 3A (DNMT3A), most frequently at arginine 882 (DNMT3A R882), have been observed in AML and in individuals with clonal hematopoiesis in the absence of leukemic transformation. Patients with DNMT3A R882 AML have an inferior outcome when treated with standard-dose daunorubicin-based induction chemotherapy, suggesting that DNMT3A R882 cells persist and drive relapse. We found that Dnmt3a mutations induced hematopoietic stem cell expansion, cooperated with mutations in the FMS-like tyrosine kinase 3 gene (Flt3 ITD) and the nucleophosmin gene (Npm1 c) to induce AML in vivo, and promoted resistance to anthracycline chemotherapy. In patients with AML, the presence of DNMT3A R882 mutations predicts minimal residual disease, underscoring their role in AML chemoresistance. DNMT3A R882 cells showed impaired nucleosome eviction and chromatin remodeling in response to anthracycline treatment, which resulted from attenuated recruitment of histone chaperone SPT-16 following anthracycline exposure. This defect led to an inability to sense and repair DNA torsional stress, which resulted in increased mutagenesis. Our findings identify a crucial role for DNMT3A R882 mutations in driving AML chemoresistance and highlight the importance of chromatin remodeling in response to cytotoxic chemotherapy.
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Mouse models carrying loss-of-function mutations in either TET2 or DNMT3A show an HSC competitive advantage in vivo as well as a propensity for leukemia when cooperating mutations are present.
“Mouse models carrying loss-of-function mutations in either of these genes clearly show an HSC competitive advantage in vivo as well as a propensity for leukemia when cooperating mutations are present 50–53.”
From Clonal hematopoiesis in human aging and disease (2019) · cites this paper as [52]
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- Authors
- Guryanova, O. A., Shank, K., Spitzer, B., Luciani, L., Koche, R. P., Garrett-Bakelman, F. E., Ganzel, C., Durham, B. H., Mohanty, A., Hoermann, G., Rivera, S. A., Chramiec, A. G., Pronier, E., Bastian, L., Keller, M. D., Tovbin, D., Loizou, E., Weinstein, A. R., Gonzalez, A. R., Lieu, Y. K., Rowe, J. M., Pastore, F., McKenney, A. S., Krivtsov, A. V., Sperr, W. R., Cross, J. R., Mason, C. E., Tallman, M. S., Arcila, M. E., Abdel-Wahab, O., Armstrong, S. A., Kubicek, S., Staber, P. B., Gönen, M., Paietta, E. M., Melnick, A. M., Nimer, S. D., Mukherjee, S., & Levine, R. L.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- University of Miami (US)
- Weill Cornell Medicine (US)
- Shaare Zedek Medical Center (IL)
- Medical University of Vienna (AT)
- Columbia University (US)
- Comprehensive Cancer Center Vienna (AT)
- Cornell University (US)
- Austrian Academy of Sciences (AT)
- Montefiore Medical Center (US)
- Corresponding author
- Mukherjee, Siddhartha
- Levine, Ross L
- ORCID
- Guryanova, Olga A
- Spitzer, Barbara
- Koche, Richard P
- Garrett-Bakelman, Francine E
- Ganzel, Chezi
- Durham, Benjamin H
- Mohanty, Abhinita
- Hoermann, Gregor
- Chramiec, Alan G
- Rowe, Jacob M
- Pastore, Friederike
- McKenney, Anna Sophia
- Krivtsov, Andrei V
- Sperr, Wolfgang R
- Cross, Justin R
- Mason, Christopher E
- Tallman, Martin S
- Arcila, Maria E
- Abdel-Wahab, Omar
- Armstrong, Scott A
- Kubicek, Stefan
- Staber, Philipp B
- Gönen, Mithat
- Paietta, Elisabeth M
- Melnick, Ari M
- Nimer, Stephen D
- Mukherjee, Siddhartha
- Levine, Ross L
- Venue
- Nature Medicine
- Published
- 2016-11-14
- Volume
- 22
- Issue
- 12
- Pages
- 1488-1495
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- PMC
- PMC5359771
- OpenAlex
- W2551286426
- Cited by
- 256
- References
- 62
- Citations by year
- 2026: 9 · 2025: 25 · 2024: 19 · 2023: 23 · 2022: 26 · 2021: 33 · 2020: 40 · 2019: 32 · 2018: 20 · 2017: 28 · 2016: 1
- FWCI
- 25.55
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- European Hematology Association (TRTH89)
- National Cancer Institute (U10CA180820, U10CA180791, UG1CA189859, R00CA178191, K08CA169055, K99CA178191, U10CA180794, R01CA169784, U10CA180827, P30CA008748, U24CA196172, K12CA184746)
- National Institute of General Medical Sciences (T32GM007739)
- Topics
- Health Sciences › Medicine › Hematology › Acute Myeloid Leukemia Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Chromatin Remodeling and Cancer
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinoids in leukemia and cellular processes
- Keywords
- acute myeloid leukemia, anthracycline resistance, nucleosome remodeling, chromatin remodeling, DNA repair, DNA torsional stress, histone chaperone, hematopoietic stem cell expansion, FLT3-ITD, NPM1, minimal residual disease, relapse
- MeSH terms
- DNA Methyltransferase 3A, Nucleophosmin, Animals, Antineoplastic Agents, Cell Survival, Daunorubicin, DNA (Cytosine-5-)-Methyltransferases, Hematopoietic Stem Cells, Humans, Mutation, Nuclear Proteins, Nucleosomes, Mass Spectrometry, Immunoblotting, Leukemia, Myeloid, Acute, Anthracyclines, Drug Resistance, Neoplasm, Chromatin Assembly and Disassembly, Cell Line, Tumor, Immunoprecipitation, Cell Proliferation, Mice, fms-Like Tyrosine Kinase 3
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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