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Front Genet. 2019 Mar 1;10:133. doi: 10.3389/fgene.2019.00133. eCollection 2019.

Epigenetic Modifications in Acute Myeloid Leukemia: Prognosis, Treatment, and Heterogeneity.

Goldman SL1,2,3, Hassan C1,2,4, Khunte M1,4, Soldatenko A1,4, Jong Y1,4, Afshinnekoo E1,2,5, Mason CE1,2,5,6.

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Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY, United States.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, NY, United States.
University of Maryland, College Park, MD, United States.
Yale College, New Haven, CT, United States.
The WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, NY, United States.
The Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, United States.


Leukemia, specifically acute myeloid leukemia (AML), is a common malignancy that can be differentiated into multiple subtypes based on leukemogenic history and etiology. Although genetic aberrations, particularly cytogenetic abnormalities and mutations in known oncogenes, play an integral role in AML development, epigenetic processes have been shown as a significant and sometimes independent dynamic in AML pathophysiology. Here, we summarize how tumors evolve and describe AML through an epigenetic lens, including discussions on recent discoveries that include prognostics from epialleles, changes in RNA function for hematopoietic stem cells and the epitranscriptome, and novel epigenetic treatment options. We further describe the limitations of treatment in the context of the high degree of heterogeneity that characterizes acute myeloid leukemia.


AML; acute myeloid leukemia; epialleles; epigenetics; heterogeneity

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