Novel epigenetic based differentiation therapy for Acute Myeloid Leukemia

Despite the development of novel therapies for acute myeloid leukemia (AML), outcomes remain poor for most patients, and therapeutic improvements are an urgent unmet need. Although treatment regimens promoting differentiation have succeeded in the treatment of acute promyelocytic leukemia (APL), their role in other AML subtypes needs to be explored. Here we identified and characterized two lysine (K) deacetylase inhibitors (DACi), CM-444 and CM-1758, exhibiting capacity to promote myeloid differentiation in all AML subtypes at low non-cytotoxic doses unlike other commercial HDACi. Analyzing the acetylome after CM-444 and CM-1758 treatment revealed modulation of non-histone proteins involved in the enhancer–promoter chromatin regulatory complex, including bromodomain proteins (BRDs). This acetylation was essential for enhancing the expression of key transcription factors directly involved in the differentiation therapy induced by CM-444/CM-1758 in AML. In summary, these compounds may represent effective differentiation-based therapeutic agents across AML subtypes with a novel mechanism for treatment of AML. Overall design: Epigenetic small molecules like CM-444, compared to commercial differentiation agents like panobinostat, used for AML differentiation.