Multi-omics integration reveals immune hallmarks and biomarkers associated with FLT3 inhibitor sensitivity in FLT3-mutated AML

Acute myeloid leukemia (AML) is an aggressive hematologic malignancy characterized by poor clinical outcomes, frequently exacerbated by mutations in the FMS-like tyrosine kinase 3 (FLT3) gene. Although FLT3 inhibitors (FLT3i) have emerged as promising therapeutic agents, the absence of molecular bio...

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Main Authors: Mingming Niu, Ning Wang, Dandan Yang, Lixia Fu, Yang Yang, Long Shen, Hong Wang, Xianfeng Shao
Format: Article
Language:English
Published: Wolters Kluwer Health 2025-06-01
Series:Blood Science
Online Access:http://journals.lww.com/10.1097/BS9.0000000000000227
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author Mingming Niu
Ning Wang
Dandan Yang
Lixia Fu
Yang Yang
Long Shen
Hong Wang
Xianfeng Shao
author_facet Mingming Niu
Ning Wang
Dandan Yang
Lixia Fu
Yang Yang
Long Shen
Hong Wang
Xianfeng Shao
author_sort Mingming Niu
collection DOAJ
description Acute myeloid leukemia (AML) is an aggressive hematologic malignancy characterized by poor clinical outcomes, frequently exacerbated by mutations in the FMS-like tyrosine kinase 3 (FLT3) gene. Although FLT3 inhibitors (FLT3i) have emerged as promising therapeutic agents, the absence of molecular biomarkers to predict FLT3i response remains a critical limitation in clinical practice. In this study, we performed a comprehensive multi-omics analysis integrating transcriptomic, proteomic, and pharmacogenomic data from the Beat AML cohort, the Cancer Cell Line Encyclopedia (CCLE), and the PXD023201 repository to elucidate the molecular consequences of FLT3 mutations in AML. Our analysis revealed significant differences in RNA and protein expression profiles between FLT3-mutant and wild-type AML cases, with a particularly striking association between FLT3 mutations and immune suppression. We further evaluated the drug sensitivity of FLT3-mutant patients to 3 FDA-approved FLT3i, gilteritinib, midostaurin, and quizartinib, and observed heightened sensitivity in FLT3-mutant cohorts, accompanied by the activation of immune-related pathways in treatment-responsive groups. These findings suggest a potential synergy between FLT3i efficacy and immune activation. Through rigorous bioinformatic analysis, we identified 3 candidate biomarkers: CD36, SASH1, and NIBAN2, associated with FLT3i sensitivity. These biomarkers were consistently upregulated in favorable prognostic subgroups and demonstrated strong correlations with immune activation pathways. The identification of CD36, SASH1, and NIBAN2 as predictive biomarkers offers a novel toolset for stratifying FLT3i response and prognosis.
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spelling doaj-art-b86505683aba4a21bb7828a2bb9466532025-08-20T03:40:21ZengWolters Kluwer HealthBlood Science2543-63682025-06-0172e0022710.1097/BS9.0000000000000227202506000-00005Multi-omics integration reveals immune hallmarks and biomarkers associated with FLT3 inhibitor sensitivity in FLT3-mutated AMLMingming Niu0Ning Wang1Dandan Yang2Lixia Fu3Yang Yang4Long Shen5Hong Wang6Xianfeng Shao7a State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, National Clinical Research Center for Blood Diseases, PUMC Department of Stem Cell and Regenerative Medicine, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, Chinaa State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, National Clinical Research Center for Blood Diseases, PUMC Department of Stem Cell and Regenerative Medicine, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, Chinaa State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, National Clinical Research Center for Blood Diseases, PUMC Department of Stem Cell and Regenerative Medicine, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, Chinaa State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, National Clinical Research Center for Blood Diseases, PUMC Department of Stem Cell and Regenerative Medicine, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, Chinaa State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, National Clinical Research Center for Blood Diseases, PUMC Department of Stem Cell and Regenerative Medicine, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, Chinaa State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, National Clinical Research Center for Blood Diseases, PUMC Department of Stem Cell and Regenerative Medicine, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, Chinaa State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, National Clinical Research Center for Blood Diseases, PUMC Department of Stem Cell and Regenerative Medicine, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, Chinaa State Key Laboratory of Experimental Hematology, Haihe Laboratory of Cell Ecosystem, National Clinical Research Center for Blood Diseases, PUMC Department of Stem Cell and Regenerative Medicine, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, ChinaAcute myeloid leukemia (AML) is an aggressive hematologic malignancy characterized by poor clinical outcomes, frequently exacerbated by mutations in the FMS-like tyrosine kinase 3 (FLT3) gene. Although FLT3 inhibitors (FLT3i) have emerged as promising therapeutic agents, the absence of molecular biomarkers to predict FLT3i response remains a critical limitation in clinical practice. In this study, we performed a comprehensive multi-omics analysis integrating transcriptomic, proteomic, and pharmacogenomic data from the Beat AML cohort, the Cancer Cell Line Encyclopedia (CCLE), and the PXD023201 repository to elucidate the molecular consequences of FLT3 mutations in AML. Our analysis revealed significant differences in RNA and protein expression profiles between FLT3-mutant and wild-type AML cases, with a particularly striking association between FLT3 mutations and immune suppression. We further evaluated the drug sensitivity of FLT3-mutant patients to 3 FDA-approved FLT3i, gilteritinib, midostaurin, and quizartinib, and observed heightened sensitivity in FLT3-mutant cohorts, accompanied by the activation of immune-related pathways in treatment-responsive groups. These findings suggest a potential synergy between FLT3i efficacy and immune activation. Through rigorous bioinformatic analysis, we identified 3 candidate biomarkers: CD36, SASH1, and NIBAN2, associated with FLT3i sensitivity. These biomarkers were consistently upregulated in favorable prognostic subgroups and demonstrated strong correlations with immune activation pathways. The identification of CD36, SASH1, and NIBAN2 as predictive biomarkers offers a novel toolset for stratifying FLT3i response and prognosis.http://journals.lww.com/10.1097/BS9.0000000000000227
spellingShingle Mingming Niu
Ning Wang
Dandan Yang
Lixia Fu
Yang Yang
Long Shen
Hong Wang
Xianfeng Shao
Multi-omics integration reveals immune hallmarks and biomarkers associated with FLT3 inhibitor sensitivity in FLT3-mutated AML
Blood Science
title Multi-omics integration reveals immune hallmarks and biomarkers associated with FLT3 inhibitor sensitivity in FLT3-mutated AML
title_full Multi-omics integration reveals immune hallmarks and biomarkers associated with FLT3 inhibitor sensitivity in FLT3-mutated AML
title_fullStr Multi-omics integration reveals immune hallmarks and biomarkers associated with FLT3 inhibitor sensitivity in FLT3-mutated AML
title_full_unstemmed Multi-omics integration reveals immune hallmarks and biomarkers associated with FLT3 inhibitor sensitivity in FLT3-mutated AML
title_short Multi-omics integration reveals immune hallmarks and biomarkers associated with FLT3 inhibitor sensitivity in FLT3-mutated AML
title_sort multi omics integration reveals immune hallmarks and biomarkers associated with flt3 inhibitor sensitivity in flt3 mutated aml
url http://journals.lww.com/10.1097/BS9.0000000000000227
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