A combination of Dihydroartemisinin and Venetoclax enhances antitumor effect in AML via C-MYC/BCL-XL/MCL-1 triple targeting

Abstract Background Acute myeloid leukemia (AML) is associated with high rates of resistance to standard therapies, necessitating the exploration of novel treatment strategies. Venetoclax (VEN) has shown efficacy in AML, yet drug resistance remains a significant challenge. This study aims to explore...

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Main Authors: Fenglin Li, Yao Chen, Haihui Zhuang, Renzhi Pei, Yuyu Lu, Dong chen, Shuangyue Li, Peipei Ye, Jiaying lian, Ying Lu
Format: Article
Language:English
Published: Springer 2025-04-01
Series:Discover Oncology
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Online Access:https://doi.org/10.1007/s12672-025-02242-7
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author Fenglin Li
Yao Chen
Haihui Zhuang
Renzhi Pei
Yuyu Lu
Dong chen
Shuangyue Li
Peipei Ye
Jiaying lian
Ying Lu
author_facet Fenglin Li
Yao Chen
Haihui Zhuang
Renzhi Pei
Yuyu Lu
Dong chen
Shuangyue Li
Peipei Ye
Jiaying lian
Ying Lu
author_sort Fenglin Li
collection DOAJ
description Abstract Background Acute myeloid leukemia (AML) is associated with high rates of resistance to standard therapies, necessitating the exploration of novel treatment strategies. Venetoclax (VEN) has shown efficacy in AML, yet drug resistance remains a significant challenge. This study aims to explore the synergistic effects of combining dihydroartemisinin (DHA) with VEN to improve therapeutic outcomes in AML. Methods AML cell lines and primary cells from AML patients were treated with various concentrations of DHA, VEN and their combined regimen. The cytotoxic effects were evaluated using MTS assays, flow cytometry for apoptosis analysis, and cell cycle assessments. Protein levels of caspase-3, PARP, MCL-1, BCL-XL and C-MYC were analyzed to elucidate the underlying mechanisms of the observed synergy. Results The combination of VEN and DHA demonstrated a significant synergistic cytotoxic effect on AML cells, characterized by reduced cell proliferation, induced apoptosis, and cell cycle arrest in the G0/G1 phase. Mechanistically, the synergy was associated with increased levels of cleaved caspase-3 and PARP, along with the downregulation of anti-apoptotic proteins MCL-1 and BCL-XL. Additionally, the combined treatment led to a significant decrease in C-MYC expression. This synergistic effect was consistently observed across all primary AML patient samples analyzed. Conclusion The findings suggest that the combination of VEN and DHA exerts synergistic anti-leukemic effects by targeting BCL-XL, MCL-1 and C-MYC, offering a promising therapeutic strategy for AML.
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spelling doaj-art-4831e79ce991401488ac99c22f94be332025-08-20T02:11:42ZengSpringerDiscover Oncology2730-60112025-04-0116111010.1007/s12672-025-02242-7A combination of Dihydroartemisinin and Venetoclax enhances antitumor effect in AML via C-MYC/BCL-XL/MCL-1 triple targetingFenglin Li0Yao Chen1Haihui Zhuang2Renzhi Pei3Yuyu Lu4Dong chen5Shuangyue Li6Peipei Ye7Jiaying lian8Ying Lu9Department of Hematology, The Affiliated People’s Hospital of Ningbo UniversityDepartment of Hematology, The Affiliated People’s Hospital of Ningbo UniversityDepartment of Hematology, The Affiliated People’s Hospital of Ningbo UniversityDepartment of Hematology, The Affiliated People’s Hospital of Ningbo UniversityDepartment of Hematology, The Affiliated People’s Hospital of Ningbo UniversityDepartment of Hematology, The Affiliated People’s Hospital of Ningbo UniversityDepartment of Hematology, The Affiliated People’s Hospital of Ningbo UniversityDepartment of Hematology, The Affiliated People’s Hospital of Ningbo UniversityDepartment of Hematology, The Affiliated People’s Hospital of Ningbo UniversityDepartment of Hematology, The Affiliated People’s Hospital of Ningbo UniversityAbstract Background Acute myeloid leukemia (AML) is associated with high rates of resistance to standard therapies, necessitating the exploration of novel treatment strategies. Venetoclax (VEN) has shown efficacy in AML, yet drug resistance remains a significant challenge. This study aims to explore the synergistic effects of combining dihydroartemisinin (DHA) with VEN to improve therapeutic outcomes in AML. Methods AML cell lines and primary cells from AML patients were treated with various concentrations of DHA, VEN and their combined regimen. The cytotoxic effects were evaluated using MTS assays, flow cytometry for apoptosis analysis, and cell cycle assessments. Protein levels of caspase-3, PARP, MCL-1, BCL-XL and C-MYC were analyzed to elucidate the underlying mechanisms of the observed synergy. Results The combination of VEN and DHA demonstrated a significant synergistic cytotoxic effect on AML cells, characterized by reduced cell proliferation, induced apoptosis, and cell cycle arrest in the G0/G1 phase. Mechanistically, the synergy was associated with increased levels of cleaved caspase-3 and PARP, along with the downregulation of anti-apoptotic proteins MCL-1 and BCL-XL. Additionally, the combined treatment led to a significant decrease in C-MYC expression. This synergistic effect was consistently observed across all primary AML patient samples analyzed. Conclusion The findings suggest that the combination of VEN and DHA exerts synergistic anti-leukemic effects by targeting BCL-XL, MCL-1 and C-MYC, offering a promising therapeutic strategy for AML.https://doi.org/10.1007/s12672-025-02242-7AML VENDHAMCL-1C-MYC
spellingShingle Fenglin Li
Yao Chen
Haihui Zhuang
Renzhi Pei
Yuyu Lu
Dong chen
Shuangyue Li
Peipei Ye
Jiaying lian
Ying Lu
A combination of Dihydroartemisinin and Venetoclax enhances antitumor effect in AML via C-MYC/BCL-XL/MCL-1 triple targeting
Discover Oncology
AML VEN
DHA
MCL-1
C-MYC
title A combination of Dihydroartemisinin and Venetoclax enhances antitumor effect in AML via C-MYC/BCL-XL/MCL-1 triple targeting
title_full A combination of Dihydroartemisinin and Venetoclax enhances antitumor effect in AML via C-MYC/BCL-XL/MCL-1 triple targeting
title_fullStr A combination of Dihydroartemisinin and Venetoclax enhances antitumor effect in AML via C-MYC/BCL-XL/MCL-1 triple targeting
title_full_unstemmed A combination of Dihydroartemisinin and Venetoclax enhances antitumor effect in AML via C-MYC/BCL-XL/MCL-1 triple targeting
title_short A combination of Dihydroartemisinin and Venetoclax enhances antitumor effect in AML via C-MYC/BCL-XL/MCL-1 triple targeting
title_sort combination of dihydroartemisinin and venetoclax enhances antitumor effect in aml via c myc bcl xl mcl 1 triple targeting
topic AML VEN
DHA
MCL-1
C-MYC
url https://doi.org/10.1007/s12672-025-02242-7
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