IntroductionThe t(8;21)(q22;q22) translocation is associated with nearly 40% of cases of the French-American-British (FAB) M2 subtype of acute myeloid leukemia (AML) and 8% to 20% of all cases of AML. [1][2][3][4] The AML1-ETO fusion protein generated due to this translocation contains the N-terminus of AML1 (also known as RUNX1, CBF␣2, PEBP2␣B) and almost full-length ETO (also known as MTG8). 5,6 The AML1 portion of AML1-ETO contains the Drosophila melanogaster protein Runt homology domain, which is essential for binding to DNA with its heterodimerization partner CBF, and lacks the C-terminal region required for transcriptional regulation. 7-13 AML1 modulates both growth and differentiation, and the analysis of Aml1 knockout mice demonstrates that AML1 is a crucial factor for definitive hematopoiesis. 14,15 In vitro studies showed that AML1 regulates the expression of growth factor receptors, cytokines, and enzymes involved in hematopoiesis. [16][17][18][19][20][21] More recently, AML1 was shown to have a role in the self-renewal potential and expansion of hematopoietic stem cells. [22][23][24] ETO contains 4 Nervy homology regions (NHR1-4) (reviewed by Peterson et al 25 ). NHR1 has sequence homology to TAF110 (TATA box binding protein-associated factor 110) and has been shown to associate with E proteins and Gfi-1. NHR2 contains a hydrophobic amino acid heptad repeat (HHR) and is critical for interactions with ETO family members (MTG8, MTG16, and MTGR1), oligomerization of AML1-ETO, and protein-protein interaction with proteins such as mSin3A, Gfi-1, BCL6, HDAC1, and HDAC3. NHR3 includes a predicted coiled-coil structure with a potential PKA-anchoring protein (AKAP) function. NHR4 also known as the myeloid-Nervy-DEAF1 (MYND) homology domain contains 2 zinc chelating centers and mediates protein-protein interactions with the corepressor complexes of nuclear receptor corepressor (NCoR) and silencing mediator for retinoid and thyroid hormone receptors (SMRT). Targeted disruption of Eto revealed an important role in the gastrointestinal system. 26 The ETO portion of AML1-ETO was shown to recruit NCoR/SMRT-Sin3-histone deacetylase (HDAC) complexes, decreasing histone acetylation and chromatin accessibility at AML1 targets. [27][28][29] Various AML1 consensus DNA-binding sequences have been reported as PuACCPuCA (TG T / C GGT T / C ), 30 TTTGCGGTT A / T , 31 and PyGPyGGTPy ( T / C G C / T GGT T / C ). 32 Furthermore, PCR-based random sequence screening with purified bacterially expressed GST-tagged AML1a (aa's 1-250) determined the AML1 consensus DNA-binding sequence as TG T / C GGT. 7 Since AML1-ETO contains the AML1 DNA-binding domain, it is generally believed that AML1-ETO binds to the same DNA sequence as AML1.Previously, we reported that although full-length AML1-ETO is not leukemogenic in mice, a C-terminal truncated version of this fusion protein (AML1-ETOtr) is highly leukemogenic. 33 Moreover, we identified an alternatively spliced variant of AML1-ETO that includes ETO exon 9a and generates the fusion prot...