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Updated: Dec 9, 2025

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Published on: June 6, 2025
The role of autophagy in targeted therapy for acute myeloid leukemia
Wenxin Du1, Aixiao Xu1, Yunpeng Huang1
1Zhejiang Province Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China.
Abstract:
Although molecular targeted therapies have recently displayed therapeutic effects in acute myeloid leukemia (AML), limited response and acquired resistance remain common problems. Numerous studies have associated autophagy, an essential degradation process involved in the cellular response to stress, with the development and therapeutic response of cancers including AML. Thus, we review studies on the role of autophagy in AML development and summarize the linkage between autophagy and several recurrent genetic abnormalities in AML, highlighting the potential of capitalizing on autophagy modulation in targeted therapy for AML.Abbreviations: AML: acute myeloid leukemia; AMPK: AMP-activated protein kinase; APL: acute promyelocytic leukemia; ATG: autophagy related; ATM: ATM serine/threonine kinase; ATO: arsenic trioxide; ATRA: all trans retinoic acid; BCL2: BCL2 apoptosis regulator; BECN1: beclin 1; BET proteins, bromodomain and extra-terminal domain family; CMA: chaperone-mediated autophagy; CQ: chloroquine; DNMT, DNA methyltransferase; DOT1L: DOT1 like histone lysine methyltransferase; FLT3: fms related receptor tyrosine kinase 3; FIS1: fission, mitochondrial 1; HCQ: hydroxychloroquine; HSC: hematopoietic stem cell; IDH: isocitrate dehydrogenase; ITD: internal tandem duplication; KMT2A/MLL: lysine methyltransferase 2A; LSC: leukemia stem cell; MDS: myelodysplastic syndromes; MTORC1: mechanistic target of rapamycin kinase complex 1; MAP1LC3/LC3: microtubule associated protein 1 light chain 3; NPM1: nucleophosmin 1; PIK3C3/VPS34: phosphatidylinositol 3-kinase catalytic subunit type 3; PML: PML nuclear body scaffold; ROS: reactive oxygen species; RB1CC1/FIP200: RB1 inducible coiled-coil 1; SAHA: vorinostat; SQSTM1: sequestosome 1; TET2: tet methylcytosine dioxygenase 2; TKD: tyrosine kinase domain; TKI: tyrosine kinase inhibitor; TP53/p53: tumor protein p53; ULK1: unc-51 like autophagy activating kinase 1; VPA: valproic acid; WDFY3/ALFY: WD repeat and FYVE domain containing 3.
Insights
Autophagy plays a key role in acute myeloid leukemia (AML) development and treatment response. Modulating autophagy offers a promising strategy for targeted AML therapy, especially given resistance to current treatments.
Area of Science:
- Oncology
- Cellular Biology
- Molecular Medicine
Background:
- Molecular targeted therapies show promise in acute myeloid leukemia (AML), but limited response and acquired resistance are significant challenges.
- Autophagy, a cellular degradation process, is increasingly recognized for its involvement in cancer development and response to therapy, including AML.
Purpose of the Study:
- To review the role of autophagy in the development of acute myeloid leukemia (AML).
- To summarize the connection between autophagy and common genetic abnormalities in AML.
- To highlight the potential of targeting autophagy for novel AML therapies.
Main Methods:
- Comprehensive literature review of studies on autophagy in AML.
- Analysis of the relationship between autophagy and recurrent genetic mutations in AML.
- Evaluation of autophagy modulation as a therapeutic strategy for AML.
Main Results:
- Autophagy is implicated in both the initiation and progression of AML.
- Specific genetic alterations in AML are linked to dysregulated autophagy pathways.
- Targeting autophagy may overcome resistance mechanisms in AML.
Conclusions:
- Autophagy is a critical factor in AML pathogenesis and treatment.
- Understanding the interplay between genetic abnormalities and autophagy is key for developing effective therapies.
- Autophagy modulation represents a promising avenue for improving targeted therapy outcomes in AML.
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