Elevated TWIST1 expression in myelodysplastic syndromes/acute myeloid leukemia reduces efficacy of hypomethylating therapy with decitabine
Hongjiao Li, Yi Wang, Xingchen Pang, Chenglian Xie, H. Joachim Deeg, Hui Wang, Ting Wan, Jinpeng Wu, Feng Guan, Xiang Li
Abstract
Myelodysplastic syndromes (MDS) comprise a heterogeneous group of myeloid neoplasms characterized by peripheral blood cytopenia, hematopoietic cell dysplasia, and transformation to secondary acute myeloid leukemia (AML) in 30% of cases. 1 Epigenetic changes are recognized as major drivers of MDS progression. A recent study indicates that DNA hypermethylation is a relevant parameter of MDS at the molecular level. 2 Treatment with demethylating compounds, decitabine, such as 5azacytidine or 5-aza-2'-deoxycytidine (DAC) increased overall survival and delayed AML transformation. 3 However, hypomethylating agents are ineffective in a substantial proportion of patients, for reasons which remain unclear.