Pharmacoepigenetics of Acute Myeloid Leukemia

The discovery of the genetic alterations that occur in acute myeloid leukemia (AML) and the ability, using modern molecular techniques, to profile the genomic and epigenomic landscape has provided new treatment avenues and therapeutic targets for the disease. Advances in biotechnology have led to the availability of molecular agents specifically directed at these targets. In recent years these agents have been made available clinically for treating patients with AML. In this chapter we will provide an overview of the regulatory mechanisms in epigenetics in AML and discuss the pharmacoepigenetics of the disease. We will survey the results of clinical trials using epigenetic modifiers as monotherapy, in conjunction with combination chemotherapy, or in dual epigenetic targeting studies. We will also discuss the outcome of patients who received epigenetic modifiers as primers of induction chemotherapy for AML. Finally, we will explore how targeting epigenetic mechanisms might enhance the immunotherapeutics of AML.