Ulrich Steidl, MD, PhD

Acute Myeloid Leukemia (AML) is a fast-growing blood cancer that is very hard to treat. Fewer than 20% of patients live more than five years after being diagnosed. One big problem is that AML often comes back after treatment or stops responding to chemotherapy, which is the main reason people die from this disease. Most research has looked at genetic changes that help cancer cells resist treatment, but new studies show that non-genetic changes also play an important role.Our research focuses on one of these non-genetic factors called “transcriptional noise.” This means natural changes in how genes are turned on and off in cells. Using advanced tools that look at single molecules, we found that chemotherapy causes a quick increase in this transcriptional noise. This seems to help leukemia cells survive the treatment. When we blocked this noise—by targeting an enzyme called Pol II that controls gene activity—the leukemia cells became more sensitive to chemotherapy. We saw this in lab tests and in mouse experiments. We also found that certain “early response” genes—genes that react fast to chemotherapy—show a lot of this noise, which means they could be new targets for drugs. Our future research will try to figure out exactly which genes are involved, how this noise helps cancer resist treatment, and which types of AML can be treated better by blocking transcriptional noise. This new approach could lead to better ways to stop drug resistance in AML and other cancers, giving patients hope for more successful treatments in the future.