Research Papers:

TWIST-1 promotes cell growth, drug resistance and progenitor clonogenic capacities in myeloid leukemia and is a novel poor prognostic factor in acute myeloid leukemia

Nan Wang _, Dan Guo, YangYang Zhao, ChengYa Dong, XiaoYan Liu, BinXia Yang, ShuWei Wang, Lin Wang, QingGuo Liu, Qian Ren, YongMin Lin and XiaoTong Ma

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Oncotarget. 2015; 6:20977-20992. https://doi.org/10.18632/oncotarget.4007

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Nan Wang1, Dan Guo1, YangYang Zhao1, ChengYa Dong1, XiaoYan Liu1, BinXia Yang1, ShuWei Wang1, Lin Wang1, QingGuo Liu1, Qian Ren1, YongMin Lin1, XiaoTong Ma1

1State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, China

Correspondence to:

XiaoTong Ma, e-mail: [email protected]

Keywords: TWIST-1, myeloid leukemia, leukemia stem cell, prognostic factor, c-MPL

Received: December 11, 2014     Accepted: May 08, 2015     Published: May 20, 2015


Alterations of TWIST-1 expression are often seen in solid tumors and contribute to tumorigenesis and cancer progression. However, studies concerning its pathogenic role in leukemia are scarce. Our study shows that TWIST-1 is overexpressed in bone marrow mononuclear cells of patients with acute myeloid leukemia (AML) and chronic myeloid leukemia (CML). Gain-of-function and loss-of-function analyses demonstrate that TWIST-1 promotes cell growth, colony formation and drug resistance of AML and CML cell lines. Furthermore, TWIST-1 is aberrantly highly expressed in CD34+CD38 leukemia stem cell candidates and its expression declines with differentiation. Down-modulation of TWIST-1 in myeloid leukemia CD34+ cells impairs their colony-forming capacity. Mechanistically, c-MPL, which is highly expressed in myeloid leukemia cells and associated with poor prognosis, is identified as a TWIST-1 coexpressed gene in myeloid leukemia patients and partially contributes to TWIST-1-mediated leukemogenic effects. Moreover, patients with higher TWIST-1 expression have shorter overall and event-free survival (OS and EFS) in AML. Multivariate analysis further demonstrates that TWIST-1 overexpression is a novel independent unfavourable predictor for both OS and EFS in AML. These data highlight TWIST-1 as a new candidate gene contributing to leukemogenesis of myeloid leukemia, and propose possible new avenues for improving risk and treatment stratification in AML.

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