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Targeting iron homeostasis induces cellular differentiation and synergizes with differentiating agents in acute myeloid leukemia
Open accessAbstract
Differentiating agents have been proposed to overcome the impaired cellular differentiation in acute myeloid leukemia (AML). However, only the combinations of all-trans retinoic acid or arsenic trioxide with chemotherapy have been successful, and only in treating acute promyelocytic leukemia (also called AML3). We show that iron homeostasis is an effective target in the treatment of AML. Iron chelating therapy induces the differentiation of leukemia blasts and normal bone marrow precursors into monocytes/macrophages in a manner involving modulation of reactive oxygen species expression and the activation of mitogen-activated protein kinases (MAPKs). 30% of the genes most strongly induced by iron deprivation are also targeted by vitamin D3 (VD), a well known differentiating agent. Iron chelating agents induce expression and phosphorylation of the VD receptor (VDR), and iron deprivation and VD act synergistically. VD magnifies activation of MAPK JNK and the induction of VDR target genes. When used to treat one AML patient refractory to chemotherapy, the combination of iron-chelating agents and VD resulted in reversal of pancytopenia and in blast differentiation. We propose that iron availability modulates myeloid cell commitment and that targeting this cellular differentiation pathway together with conventional differentiating agents provides new therapeutic modalities for AML.
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“Through a comparable pathway, cellular superoxide generation can increase after exposure to iron chelators [48,49].”
From Asbestos and Iron (2023) · cites this paper as [49]
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AcTor, a novel mTOR stimulator, potentiates ixazomib for the treatment of acute myeloid leukemia
Pattanayak, S. P., Darawshi, O., Hajihassani, O., Winter, J. M., Weiler, N., Ott, M., Rothweiler, F., Cinatl, J. J., Michaelis, M., Lindner, D. J., et al. (2026) · Molecular Cancer · doi:10.1186/s12943-026-02689-4
Metadata
- Authors
- Callens, C., Coulon, S., Naudin, J., Radford-Weiss, I., Boissel, N., Raffoux, E., Wang, P. H. M., Agarwal, S., Tamouza, H., Paubelle, E., Asnafi, V., Ribeil, J.-A., Dessen, P., Canioni, D., Chandesris, O., Rubio, M. T., Beaumont, C., Benhamou, M., Dombret, H., Macintyre, E., Monteiro, R. C., Moura, I. C., & Hermine, O.
- Affiliations
- Centre National de la Recherche Scientifique UMR 8147, Paris 75015, France 1
- Centre National de la Recherche Scientifique (FR)
- Faculté de Médecine, Université René Descartes Paris V, Institut Fédératif Necker, Paris 75015, France 2
- Assistance Publique – Hôpitaux de Paris (FR)
- Inserm (FR)
- Hôpital Necker-Enfants Malades (FR)
- Institut Gustave Roussy (FR)
- Corresponding author
- Hermine, Olivier
- ORCID
- Venue
- Journal of Experimental Medicine
- Publisher
- Rockefeller University Press
- Published
- 2010-04-05
- Volume
- 207
- Issue
- 4
- Pages
- 731-750
- ISSN
- 0022-1007 (ISSN-L)
- 1540-9538
- PMC
- PMC2856037
- OpenAlex
- W2137774959
- Cited by
- 197
- References
- 76
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 5 · 2023: 14 · 2022: 11 · 2021: 15 · 2020: 13 · 2019: 9 · 2018: 13 · 2017: 12 · 2016: 11 · 2015: 13 · 2014: 13 · 2013: 9 · 2012: 20
- FWCI
- 11.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Experimental Medicine (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Funders
- Institut National de la Santé et de la Recherche Médicale
- Fondation pour la Recherche Médicale
- Fondation de France
- Topics
- Health Sciences › Medicine › Hematology › Acute Myeloid Leukemia Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinoids in leukemia and cellular processes
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Keywords
- acute myeloid leukemia, iron homeostasis, iron chelation, iron starvation, cell differentiation, vitamin D3, vitamin D receptor, reactive oxygen species, monocyte-to-macrophage differentiation, pancytopenia, combination therapy, refractory leukemia
- MeSH terms
- Iron Deficiencies, Aged, Animals, Antibodies, Monoclonal, Blood Cell Count, Cell Differentiation, Cholecalciferol, Drug Synergism, Female, Granulocytes, Hematopoietic Stem Cells, Homeostasis, Humans, Hydroxycholecalciferols, Iron, Iron Chelating Agents, Male, Mice, Nude, Monocytes, Phosphorylation, Receptors, Transferrin, Leukemia, Myeloid, Acute, Antigens, CD, Gene Expression, Apoptosis, Reactive Oxygen Species, Receptors, Calcitriol, Lipopolysaccharide Receptors, Gene Expression Profiling, Mitogen-Activated Protein Kinases, Xenograft Model Antitumor Assays, CD11b Antigen, Cell Line, Tumor, JNK Mitogen-Activated Protein Kinases, Cell Proliferation, Mice, Kaplan-Meier Estimate
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