[HTML][HTML] RAS mutations drive proliferative chronic myelomonocytic leukemia via a KMT2A-PLK1 axis

RM Carr, D Vorobyev, T Lasho, DL Marks… - Nature …, 2021 - nature.com
RM Carr, D Vorobyev, T Lasho, DL Marks, EJ Tolosa, A Vedder, LL Almada, A Yurcheko
Nature communications, 2021nature.com
Proliferative chronic myelomonocytic leukemia (pCMML), an aggressive CMML subtype, is
associated with dismal outcomes. RAS pathway mutations, mainly NRAS G12D, define the
pCMML phenotype as demonstrated by our exome sequencing, progenitor colony assays
and a Vav-Cre-Nras G12D mouse model. Further, these mutations promote CMML
transformation to acute myeloid leukemia. Using a multiomics platform and biochemical and
molecular studies we show that in pCMML RAS pathway mutations are associated with a …
Abstract
Proliferative chronic myelomonocytic leukemia (pCMML), an aggressive CMML subtype, is associated with dismal outcomes. RAS pathway mutations, mainly NRASG12D, define the pCMML phenotype as demonstrated by our exome sequencing, progenitor colony assays and a Vav-Cre-NrasG12D mouse model. Further, these mutations promote CMML transformation to acute myeloid leukemia. Using a multiomics platform and biochemical and molecular studies we show that in pCMML RAS pathway mutations are associated with a unique gene expression profile enriched in mitotic kinases such as polo-like kinase 1 (PLK1). PLK1 transcript levels are shown to be regulated by an unmutated lysine methyl-transferase (KMT2A) resulting in increased promoter monomethylation of lysine 4 of histone 3. Pharmacologic inhibition of PLK1 in RAS mutant patient-derived xenografts, demonstrates the utility of personalized biomarker-driven therapeutics in pCMML.
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