CIP2A- and SETBP1-mediated PP2A inhibition reveals AKT S473 phosphorylation to be a new biomarker in AML by Claire M. Lucas, Laura J. Scott, Natasha Carmell,

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CIP2A- and SETBP1-mediated PP2A inhibition reveals AKT S473 phosphorylation to be a new biomarker in AML by Claire M. Lucas, Laura J. Scott, Natasha Carmell, Alison K. Holcroft, Robert K. Hills, Alan K. Burnett, and Richard E. Clark BloodAdv Volume 2(9):964-968 May 8, 2018 © 2018 by The American Society of Hematology

Claire M. Lucas et al. Blood Adv 2018;2:964-968 © 2018 by The American Society of Hematology

High CIP2A-expressing patients have inferior survival from relapse. High CIP2A-expressing patients have inferior survival from relapse. (A) Diagnostic CIP2A protein level in 120 AML patients. AML15 are younger patients; AML16 are older patients. AML15 normal karyotype (N = 39); AML15 adverse karyotype (n = 40); and AML16 normal karyotype (N = 41). (B) AML15 normal karyotype patients stratified by diagnostic CIP2A level. P values are only significant where shown. Survival from relapse. The numbers of assessable cases are shown below each plot. The log-rank test was used for Kaplan-Meier estimates. (C) CIP2A level stratified by FLT3-ITD mutation status. *Denotes statistical significance when compared to normal MNC cells. Claire M. Lucas et al. Blood Adv 2018;2:964-968 © 2018 by The American Society of Hematology

Patients with detectable SETBP1 protein at diagnosis have inferior overall survival. Patients with detectable SETBP1 protein at diagnosis have inferior overall survival. (A) SETBP1 protein expression is significantly elevated in younger AML patients with adverse karyotype (P = .001; Mann-Whitney U test). Error bars are standard error of mean. (B) Kaplan-Meier estimates for overall survival in all patients. All AML patients are stratified into diagnostic SETBP1 terciles: absent (T1), intermediate (T2), and high (T3). (C) Young adverse patients. (D) Relapse-free survival for younger adverse AML patients, stratified by the SETBP1 level at diagnosis. The numbers of assessable cases are shown below each plot. (E) High AKTS473 level is associated with inferior overall survival. (F) Kaplan-Meier estimates for overall survival for young adverse AML patients stratified by quartiles according to the AKTS473 level at diagnosis. High AKTS473 level is associated with inferior overall survival (P = .05; log-rank test). (G) Suggested model of PP2A inhibition in AML. In normal karyotype patients, PP2A is inhibited predominately by CIP2A whereas in adverse-risk patients, SETBP1 inhibition dominates. PP2A inhibition from either source results in high levels of AKTS473. *Denotes statistical significance when compared to normal MNC cells. CR, complete remission. Claire M. Lucas et al. Blood Adv 2018;2:964-968 © 2018 by The American Society of Hematology