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Publication : Hotspot DNMT3A mutations in clonal hematopoiesis and acute myeloid leukemia sensitize cells to azacytidine via viral mimicry response.

First Author  Scheller M Year  2021
Journal  Nat Cancer Volume  2
Issue  5 Pages  527-544
PubMed ID  35122024 Mgi Jnum  J:334992
Mgi Id  MGI:7464981 Doi  10.1038/s43018-021-00213-9
Citation  Scheller M, et al. (2021) Hotspot DNMT3A mutations in clonal hematopoiesis and acute myeloid leukemia sensitize cells to azacytidine via viral mimicry response. Nat Cancer 2(5):527-544
abstractText  Somatic mutations in DNA methyltransferase 3A (DNMT3A) are among the most frequent alterations in clonal hematopoiesis (CH) and acute myeloid leukemia (AML), with a hotspot in exon 23 at arginine 882 (DNMT3A(R882)). Here, we demonstrate that DNMT3A(R882H)-dependent CH and AML cells are specifically susceptible to the hypomethylating agent azacytidine (AZA). Addition of AZA to chemotherapy prolonged AML survival solely in individuals with DNMT3A(R882) mutations, suggesting its potential as a predictive marker for AZA response. AML and CH mouse models confirmed AZA susceptibility specifically in DNMT3A(R882H)-expressing cells. Hematopoietic stem cells (HSCs) and progenitor cells expressing DNMT3A(R882H) exhibited cell autonomous viral mimicry response as a result of focal DNA hypomethylation at retrotransposon sequences. Administration of AZA boosted hypomethylation of retrotransposons specifically in DNMT3A(R882H)-expressing cells and maintained elevated levels of canonical interferon-stimulated genes (ISGs), thus leading to suppressed protein translation and increased apoptosis.
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