Molecular Targeting of High-Risk Pediatric Leukemia: Identification of Targets and Biological Implications for Therapy

dc.contributor.advisorNarendran, Aru
dc.contributor.authorSharma, Ritul
dc.contributor.committeememberChilds, Sarah
dc.contributor.committeememberNeri, Paola
dc.contributor.committeememberRiabowol, Karl
dc.date2025-06
dc.date.accessioned2024-11-28T18:05:40Z
dc.date.available2024-11-28T18:05:40Z
dc.date.issued2024-11-26
dc.description.abstractAcute leukemias with KMT2A (mixed-lineage leukemia or MLL) rearrangements are associated with poor prognosis and high relapse rates, particularly in infant and pediatric populations. The outcomes for patients with KMT2A-rearranged (KMT2A-r) leukemia remain suboptimal, underscoring the urgent need for novel, targeted therapeutic approaches. This thesis focuses on disrupting key molecular interactions within the KMT2A fusion protein complex that drives leukemogenesis while characterizing novel preclinical models to facilitate targeted drug discovery. By utilizing established cell line models, cell-based assays and drug combination studies, this study demonstrated the therapeutic potential of inhibiting the interaction between KMT2A fusion protein and a transcriptional kinase, CDK9. In addition, the study demonstrates that targeting CDK9 can decrease venetoclax and steroid resistance in KMT2A-r leukemia. Furthermore, this thesis investigates the biological implications of treatment induced differentiation, with a focus on identifying therapeutic strategies to treat KMT2A-r leukemias. Our results demonstrate that menin inhibitor induced differentiation in KMT2A-r cells carries a distinct inflammatory profile with elevated secretion of HMGB1 and IL-8. These cytokines are associated with promoting migratory responses. In addition, our findings showed a synergistic interaction between menin inhibition and corticosteroids, which is the first line treatment for patients with differentiation syndrome. In parallel, the study evaluates the efficacy of the ETS inhibitor TK216, targeting SPI1 overexpression in pediatric AML and B-ALL leukemias, with the goal of uncovering its therapeutic potential in high-risk pediatric leukemia. The research presented herein offers a framework for developing feasible novel therapeutic strategies for KMT2A-r leukemias, building on a foundation of preclinical modeling and mechanistic insights that may inform future clinical interventions.
dc.identifier.citationSharma, R. (2024). Molecular targeting of high-risk pediatric leukemia: identification of targets and biological implications for therapy (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.
dc.identifier.urihttps://hdl.handle.net/1880/120119
dc.language.isoen
dc.publisher.facultyGraduate Studies
dc.publisher.institutionUniversity of Calgary
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.
dc.subjectOncology
dc.subjectPediatric
dc.subjectTherapeutics
dc.subject.classificationHealth Sciences
dc.subject.classificationOncology
dc.titleMolecular Targeting of High-Risk Pediatric Leukemia: Identification of Targets and Biological Implications for Therapy
dc.typedoctoral thesis
thesis.degree.disciplineMedicine – Medical Sciences
thesis.degree.grantorUniversity of Calgary
thesis.degree.nameDoctor of Philosophy (PhD)
ucalgary.thesis.accesssetbystudentI require a thesis withhold – I need to delay the release of my thesis due to a patent application, and other reasons outlined in the link above. I have/will need to submit a thesis withhold application.
Files
Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
ucalgary_2024_sharma_ritul.pdf
Size:
4.72 MB
Format:
Adobe Portable Document Format
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
2.64 KB
Format:
Item-specific license agreed upon to submission
Description: