Possibilities of epigenetic therapy of acute myeloid leukemias in children

The results of the treatment of acute myeloid leukemia (AML) in pediatric patients remain poor. The modern programs of treatment allow achieving long-term survival in only 65–70% of patients and the event-free survival rates are lower and make up approximately 55%. The development of protocols for high-intensity therapy, which are based on the «block» principle, followed by long-term maintenance therapy has led to the significant progress in the treatment of AML. As supportive care has improved, it became possible to escalate the doses of chemotherapy, which contributed to the increase of the treatment effectiveness. So far, doses and drugs administration regimens have approached the tolerated level, which necessitates the research into new therapeutic targets. An investifation of the epigenetic processes underlying leukemogenesis made it possible to identify those targets – DNA methylation and histone deacetylation. This review presents the results of the use of epigenetic drugs in the treatment of AML in children. The possibilities of including epigenetic agents in standard polychemotherapy protocols are presented.