Abstract. Aberrant promoter DNA methylation is a major mechanism of leukemogenesis in hematologic malignancies, including acute myeloid leukemia (AML). However, the association between promoter methylation with chemotherapeutic outcomes remains unknown. In the present study, bone marrow samples were collected prior to and following chemotherapy in 30 AML patients. Methylation-specific polymerase chain reaction technology was used to examine the promoter methylation status of adenomatous polyposis col 2 (APC2) and cytochrome P450 family 1 subfamily B polypeptide 1 (CYP1B1). The results revealed no change in the methylation status of the APC2 promoter in patients following various chemotherapy regimens. However, the methylation status of the CYP1B1 promoter changed in response to 6 different chemotherapy regimens. AML patients of the M3 subtype displayed an induction of the CYP1B1 promoter methylation levels more frequently (57.1%) than patients affected by the other subtypes (M1: 33.3%; M2: 12.5%; M4: 16.7%; M5: 0% and M6: 0%). In addition, a higher frequency of male patients (4/13) exhibited modulation of the CYP1B1 promoter methylation status compared with female patients (3/17). Furthermore, of five AML patients with a poor prognosis, two exhibited changes leading to CYP1B1 hypomethylation and two leading to CYP1B1 hypermethylation. By contrast, three other patients exhibited hypermethylation changes along with remission. This may be explained by the different chemotherapy regimens used to treat these patients or by other unknown factors. The present study revealed that CYP1B1 promoter methylation was induced during chemotherapy, whereas the APC2 promoter remained hemimethylated. Furthermore, the changes in CYP1B1 methylation were dependent on the AML subtypes and the gender of the patients.
IntroductionPromoter methylation is important in epigenetics and always leads to transcriptional silencing of tumor suppressor genes in acute myeloid leukemia (AML) (1). Although current chemotherapy regimens result in complete remission in many cases, there is no standard and efficient therapy for refractory AML (2). As aberrant DNA methylation is common in AML, clinical trials using epigenetically-targeted therapies have yielded particularly promising results in the treatment of hematopoietic malignancies (3). Several demethylating agents, including azacytidine and decitabine, have been demonstrated to improve AML prognosis (4).Adenomatous polyposis col 2 (APC2) is a tumor suppressor gene, encoding a protein that controls the stability and nuclear export of β-catenin, which is a Wnt signaling pathway transcriptional coactivator (5). Wnt pathway inhibitors are methylated at a high frequency in AML patients (6). The cytochrome P450 family 1 subfamily B polypeptide 1 (CYP1B1) gene, which is a candidate target gene in numerous types of cancers, encodes a member of the cytochrome P450 enzyme superfamily. Furthermore, cytochrome P450 enzymes are involved in drug metabolism and the synthesis of cholesterol, steroids and other l...