RUNX1-targeted therapy for AML expressing somatic or germline mutation in RUNX1

Christopher P. Mill, Warren Fiskus, Courtney D. DiNardo, Yimin Qian, Kanak Raina, Kimal Rajapakshe, Dimuthu Perera, Cristian Coarfa, Tapan M. Kadia, Joseph D. Khoury, Dyana T. Saenz, David N. Saenz, Anuradha Illendula, Koichi Takahashi, Steven M. Kornblau, Michael R. Green, Andrew P. Futreal, John H. Bushweller, Craig M. Crews, Kapil N. Bhalla

Research output: Contribution to journalArticlepeer-review

68 Scopus citations


RUNX1 transcription factor regulates normal and malignant hematopoiesis. Somatic or germline mutant RUNX1 (mtRUNX1) is associated with poorer outcome in acute myeloid leukemia (AML). Knockdown or inhibition of RUNX1 induced more apoptosis of AML expressing mtRUNX1 versus wild-type RUNX1 and improved survival of mice engrafted with mtRUNX1-expressing AML. CRISPR/Cas9-mediated editing-out of RUNX1 enhancer (eR1) within its intragenic super-enhancer, or BET protein BRD4 depletion by short hairpin RNA, repressed RUNX1, inhibited cell growth, and induced cell lethality in AML cells expressing mtRUNX1. Moreover, treatment with BET protein inhibitor or degrader (BET-proteolysis targeting chimera) repressed RUNX1 and its targets, inducing apoptosis and improving survival of mice engrafted with AML expressing mtRUNX1. Library of Integrated Network-based Cellular Signatures 1000-connectivity mapping data sets queried with messenger RNA signature of RUNX1 knockdown identified novel expressionmimickers (EMs), which repressed RUNX1 and exerted in vitro and in vivo efficacy against AML cells expressing mtRUNX1. In addition, the EMs cinobufagin, anisomycin, and narciclasine induced more lethality in hematopoietic progenitor cells (HPCs) expressing germline mtRUNX1 from patients with AML compared with HPCs from patients with familial platelet disorder (FPD), or normal untransformed HPCs. These findings highlight novel therapeutic agents forAML expressing somatic or germline mtRUNX1.

Original languageEnglish
Pages (from-to)59-73
Number of pages15
Issue number1
StatePublished - 4 Jul 2019
Externally publishedYes


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