Vincelette, Nicole D. and Yu, Xiaoqing and Kuykendall, Andrew T. and Moon, Jungwon and Su, Siyuan and Cheng, Chia- Ho and Sammut, Rinzine and Razabdouski, Tiffany N. and Nguyen, Hai Vu and Eksioglu, Erika A. and Chan, Onyee and Al Ali, Najla and Patel, Parth C. and Lee, Dae Hyun and Nakanishi, Shima and Ferreira, Renan B. and Mo, Qianxing and Cory, Suzanne and Lawrence, Harshani R. and Zhang, Ling and Murphy, Daniel J. and Komrokji, Rami S. and Lee, Daesung and Kaufmann, Scott H. and Cleveland, John L. and Yun, Seongseok (2024) Trisomy 8 defines a distinct subtype of myeloproliferative neoplasms driven by the MYC-alarmin axis. Blood Cancer Discovery, 5 (4). pp. 276-297. ISSN 2643-3230

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Abstract

Despite advances in understanding the genetic abnormalities in myeloproliferative neoplasms (MPNs) and the development of JAK2 inhibitors, there is an urgent need to devise new treatment strategies, particularly for triple negative myelofibrosis (MF) patients who lack mutations in the JAK2 kinase pathway and have very poor clinical outcomes. Here we report that MYC copy number gain and increased MYC expression frequently occur in triple negative MF, and that MYC-directed activation of S100A9, an alarmin protein that plays pivotal roles in inflammation and innate immunity, is necessary and sufficient to drive development and progression of MF. Notably, the MYC-S100A9 circuit provokes a complex network of inflammatory signaling that involves numerous hematopoietic cell types in the bone marrow microenvironment. Accordingly, genetic ablation of S100A9 or treatment with small molecules targeting the MYC-S100A9 pathway effectively ameliorates MF phenotypes, highlighting the MYC-alarmin axis as a novel therapeutic vulnerability for this subgroup of MPNs.

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