# Bioinformatic analysis of venetoclax sensitivity and resistance mechanisms in acute myeloid leukemia

**Authors:** 阳 杨, 成华 许, 宁 王, 金婷 范, 丹丹 杨, 明明 牛, 龙 申, 洪 王

PMC · DOI: 10.3760/cma.j.cn121090-20250114-00028 · Chinese Journal of Hematology · 2025-05-01

## TL;DR

This study investigates how venetoclax affects acute myeloid leukemia and identifies genetic factors linked to drug sensitivity and resistance.

## Contribution

The study identifies FLT3 mutations and transcription factors FOXM1 and STAT3 as key to venetoclax sensitivity and resistance in AML.

## Key findings

- Patients with FLT3 mutations show higher sensitivity to venetoclax.
- High peripheral blood tumor burden correlates with increased venetoclax sensitivity.
- FOXM1 and STAT3 transcription factor activation is linked to venetoclax resistance and shorter survival.

## Abstract

探究维奈克拉对急性髓系白血病（AML）的抑癌作用及耐药机制。

从Beat AML数据库下载BCL-2抑制剂维奈克拉药敏试验的AML患者基因组、转录组及临床信息数据，对其与药敏试验结果进行相关性分析。通过对转录组数据进行差异分析，筛选出与维奈克拉治疗敏感性相关的差异基因并使用GEO数据库转录组结果及体外实验进行验证。同时应用KEGG、GSEA以及KnockTF转录因子富集分析及公共数据库进一步探讨影响药物敏感性的关键基因。

过滤得到52例进行维奈克拉药敏试验的患者数据。分析结果表明，携带FLT3突变的患者相比无FLT3突变的患者对维奈克拉表现出更高的敏感性。临床信息与药敏试验结果的相关性分析结果显示，外周血肿瘤负荷较高的患者对维奈克拉更敏感。转录组数据分析及体外实验验证维奈克拉抑制FLT3相关信号通路。KEGG、KnockTF转录因子富集分析提示维奈克拉耐药与FOXM1、STAT3转录活性升高有关，高表达FOXM1、STAT3的患者生存期更短。

维奈克拉可以抑制FLT3相关信号通路激活，而STAT3和FOXM1转录因子的激活可能是维奈克拉耐药的关键机制之一。

## Linked entities

- **Genes:** FLT3 (fms related receptor tyrosine kinase 3) [NCBI Gene 2322], FOXM1 (forkhead box M1) [NCBI Gene 2305], STAT3 (signal transducer and activator of transcription 3) [NCBI Gene 6774]
- **Chemicals:** venetoclax (PubChem CID 49846579)
- **Diseases:** acute myeloid leukemia (MONDO:0015667)

## Full-text entities

- **Genes:** FLT3 (fms related receptor tyrosine kinase 3) [NCBI Gene 2322] {aka CD135, FLK-2, FLK2, STK1}, STAT5A (signal transducer and activator of transcription 5A) [NCBI Gene 6776] {aka MGF, STAT5}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, FOXM1 (forkhead box M1) [NCBI Gene 2305] {aka FKHL16, FOXM1A, FOXM1B, FOXM1C, HFH-11, HFH11}, STAT3 (signal transducer and activator of transcription 3) [NCBI Gene 6774] {aka ADMIO, ADMIO1, APRF, HIES}
- **Diseases:** leukemic (MESH:D007938), AML (MESH:D015470), tumor (MESH:D009369)
- **Chemicals:** Venetoclax (MESH:C579720)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12268286/full.md

## References

26 references — full list in the complete paper: https://tomesphere.com/paper/PMC12268286/full.md

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Source: https://tomesphere.com/paper/PMC12268286