Indiana University-Purdue University Indianapolis (IUPUI) / Juvenile myelomonocytic leukemia (JMML) is an aggressive myeloproliferative neoplasm that lacks effective chemotherapies. Most commonly, patients have gain-of-function (GOF) oncogenic mutations in SHP2, leading to hyperactivation of ERK and AKT and hyperproliferation of cells in response to granulocyte macrophage-colony stimulating factor (GM-CSF). Our lab previously showed that p110δ, the hematopoietic-specific catalytic subunit of phosphoinositide 3-kinase, is a crucial mediator of mutant Shp2-induced GM-CSF hypersensitivity in vitro. We treated oncogenic Shp2-expressing mice with a p110δ inhibitor and showed that the strong effect our lab observed in vitro translated into reduced splenomegaly and prolonged survival in vivo. We investigated molecules potentially cooperating with p110δ signaling and discovered that Bruton’s tyrosine kinase (BTK) is hyperphosphorylated in GOF Shp2 myeloid cells. We used specific BTK and p110δ inhibitors to demonstrate that BTK cooperates with p110δ to hyperactivate Akt/Erk and to promote hyperproliferation. GOF Shp2-expressing mice treated in vivo with the drug combination targeting p110δ and BTK have significantly decreased splenomegaly and WBC counts. We also explored the mechanism of BTK signaling and hypothesized that B cell adaptor for PI3K (BCAP) mediated BTK upregulation of PI3K activity. In mutant Shp2 macrophages, we observed BCAP phosphorylation specifically in the larger isoforms needed for PI3K activation, and BTK inhibition led to a dose-dependent reduction in this phosphorylation. We also demonstrated reduced interaction between BCAP and the PI3K regulatory p85α subunit bearing mutated SH2 domains. Finally, we investigated the effects of mutated DNA methyltransferase 3A (Dnmt3a) in conjunction with GOF Shp2. Double mutant mice quickly became moribund with pronounced splenomegaly and leukocytosis. There was an expansion of mature myeloid cells in the periphery and myeloid progenitors in the bone marrow, plus anemia with evidence of compensatory erythropoiesis in the spleen. Our findings show that the myeloproliferative neoplasm caused by GOF Shp2 is due to hyperactive p110δ, and this is further promoted by BTK, which forms a positive feedback loop with PI3K and BCAP, thus leading to more Akt/Erk hyperphosphorylation and more hyperproliferation in response to GM-CSF. The dual inhibition of p110δ and BTK represents a novel effective treatment strategy for JMML and other diseases induced by oncogenic Shp2.

L’ADN méthyltransférase 3a (DNMT3A) relie environnement et phénotype par la méthylation des dinucléotides CpG, qu’on les trouve en particulier dans les régions promotrices des gènes. Hypométhylation de ces CpG est associée à l’activation de la transcription, qui permet le contrôle de l'expression génique dans des états physiologiques et pathologiques. La plupart de nos connaissances sur l’implication de Dnmt3a en pathologie concernent le cancer, quelques données montrent sa contribution à d’autres pathologies. L’athérosclérose est la maladie cardiovasculaire la plus fréquente. Plusieurs facteurs de risque contribuant à son apparition, sont liés à L’environnement. En particulier, les dyslipidémies, largement influencées par le régime alimentaire. Par ailleurs, d’abondantes données décrivent la contribution des cellules inflammatoires à la physiopathologie de cette maladie. Jusqu'à présent, un nombre croissant de données suggère un rôle de la méthylation de l’ADN dans l'athérosclérose, mais à ce jour, le rôle de Dnmt3a dans la régulation du cholestérol et le développement initial des plaques n'a pas été étudié.Nos résultats suggèrent que l’inactivation de Dnmt3a dans les monocytes/macrophages ne modifie pas le développement initial des plaques d’athérome et n’a pas d’influence sur la polarisation des macrophages in vitro. En parallèle, nous avons démontré que l’inactivation de Dnmt3a dans les hépatocytes conduit à une différence significative de cholestérolémie plasmatique qui n’est pas liée à une dérégulation des gènes majeurs impliqués dans le métabolisme du cholestérol. En revanche, nous avons mis en évidence une activation des réponses inflammatoires. / DNA methyltransferase 3a (DNMT3A) links environment to phenotypes via catalysis of CpG dinucleotides, notably found in genes promoter regions, methylation and whose hypomethylation is associated with gene transcriptional activation thus enabling the control of gene expression in physiologic and pathologic states. Most of our knowledge about its’ role in disease occurrence are based on articles demonstrating its’ implication in human cancers. Limited data from mouse studies illustrates its’ contribution to certain pathologies. Atherosclerosis constitutes the single most important contributor to the growing burden of cardiovascular disease. Risk factors contribute to disease occurrence, where most are related to environmental influences, notably Dyslipidaemia, a key initiator of atherosclerosis. Abundant data link hypercholesterolemia to atherogenesis, on the other hand, contribution of inflammatory mechanisms that couple dyslipidaemia to atheroma formation has been also appreciated. So far, a growing number of data suggests a role of Dnmt3a in atherosclerosis but to date, its role in cholesterol regulation and early plaque formation has not been clearly elucidated. Our results suggested that deletion of Dnmt3a in monocyte/macrophages does not affect the formation of early atherosclerostic plaque nor does it impact the polarization of macrophages in vitro. In parallel, we have also demonstrated that the deletion of Dnmt3a in hepatocytes leads to significant elevation in TC levels. We were not able to relate this elevation to dysregulation of major genes involved in Cholesterol regulation. On the other hand, we noticed activation of hepatic inflammatory responses.

Les protéines de la famille TET catalysent l'oxydation des 5-méthylcytosines (5mC) en 5-hydroxyméthylcytosines (5hmC) et jouent ainsi un rôle dans la régulation épigénétique de la transcription et dans le processus de déméthylation de l'ADN. Les interactions entre la méthylation de l'ADN et les autres marques épigénétiques sont encore mal connues.Des mutations inactivatrices du gène TET2 ont été décrites dans les hémopathies myéloïdes et lymphoïdes et l'inactivation conditionnelle (cKO) de ce gène évaluée chez la souris a permis d'identifier de multiples anomalies de l'hématopoïèse, ainsi que le développement tardif d'hémopathies myéloïdes. Cette latence importante suggère la nécessité d'évènements oncogéniques coopératifs pour la transformation hématopoïétique. Chez l'Homme, les mutations de TET2 sont observées en association avec de nombreuses autres mutations, et en particulier avec des mutations du gène DNMT3A impliqué dans la méthylation de novo des cytosines de l'ADN, et avec des mutations du gène EZH2 responsable de methylation de la lysine 27 de l'histone H3. Nous avons testé fonctionnellement ces associations en utilisant des modèles murins.L'utilisation d'un modèle de transplantation de moelle osseuse nous a permis d'identifier une coopération de l'inactivation de Tet2 et du mutant DNMT3AR882H dans la transformation des lignées myéloïdes et lymphoïde T, correspondant aux hémopathies humaines porteuses de ces mutations. Dans la transformation lymphoïde, nos données indiquent que la dérégulation de la méthylation entraine une surexpression du gène NOTCH1 et de l'activité de la voie de signalisation correspondante.L'analyse de souris invalidées de manière conditionnelle pour Tet2 et Ezh2 a montré que les souris correspondantes meurent d'aplasie médullaire, dont l'origine est imputée à la disparition de cellules souches hématopoïétiques capables de reconstituer l'hématopoïèse à long terme (LT-HSC). Ezh2 et Tet2 ont donc des rôles primordiaux dans le maintien de l'autorenouvellement des cellules souches hématopoïétiques, dont les mécanismes moléculaires, génétiques et épigénétiques restent à définir. / TET family proteins catalyzing the conversion of 5-methylcytosines (5mC) into 5-hydroxymethylcytosines (5hmC) are crucial for epigenetic regulation of transcription and for DNA demethylation. Interactions between DNA methylation and other epigenetic marks are not fully understood.TET2 inactivating mutations have been identified in both myeloid and lymphoid malignancies. The conditional inactivation (cKO) of this gene in mice highlights pleiotropic hematopoietic abnormalities as well as myeloid transformation at late stages. This latency suggest cooperativity between Tet2 and other oncogenic events during transformation. Human TET2 mutations are frequently found associated with other mutations, and more particularly with mutations in DNMT3A, involved in de novo methylation of cytosines and with mutations in EZH2, responsible for lysine 27 of histone H3 methylation. We decided to functionally assess these mutation associations in mice.Bone marrow transplantation of Tet2 inactivated and DNMT3AR882H mutated cells allowed us to identify myeloid and T-cell transformations, corresponding to human hematological disorders harboring these mutations. Our results on T-cell transformations clearly demonstrate that the deregulation of methylation leads to NOTCH1 overexpression and activation of the corresponding signaling pathway.Analyses of Tet2 and Ezh2 inactivated mice show that these Ezh2 Tet2 mice succumb to bone marrow exhaustion, attributed to long term hematopoietic stem cells (LT-HSC) disappearance. Ezh2 and Tet2 show major roles in LT-HSC maintenance whose molecular, genetic and epigenetic mechanism remains to be investigated.

No description available.

La méthylation de l’ADN est une modification épigénétique qui prend place durant le développement embryonnaire sur le génome des Mammifères. Durant ma thèse, j’ai déterminé les cinétiques de mise en place de la méthylation de l’ADN sur le génome murin au cours de l’embryogénèse précoce. J’ai identifié les rôles spécifiques et redondants des ADN méthyltransférases DNMT3a et DNMT3b dans ce processus. J’ai également étudié le rôle de deux facteurs dans la mise en place de la méthylation de l’ADN dans l’embryon. Premièrement, j’ai déterminé que l’enzyme G9a joue un rôle essentiel pour la répression et le recrutement de la méthylation de l’ADN à des sites spécifiques du génome, incluant en particulier des promoteurs à ilots CpG de gènes méiotiques. Deuxièmement, l’étude du facteur E2F6 m’a permis de montrer que cette protéine est elle aussi impliquée dans le recrutement de la méthylation de l’ADN, et ce à des promoteurs de gènes méiotiques distincts de ceux régulés par G9a. / DNA methylation is an epigenetic modification which is established during embryonic development on the mammalian genome. In my thesis, I determined the kinetics of DNA methylation acquisition on the mouse genome during early embryogenesis, and determined the specific and redundant roles of the DNA methyltransferases DNMT3a and DNMT3b in this process. I also studied the roles of two factors involved in setting up DNA methylation in embryos. First, I determined that the G9a enzyme plays an essential role for the in vivo repression and DNA methylation of specific genomic sites, including in particular the CpG island promoters of germline genes. Second, the study of the E2F6 factor allowed me to show that this protein is also involved in recruiting DNA methylation at a set of germline gene promoters than are distinct from those regulated by G9a.

La délétion du chromosome 7q est l'anomalie cytogénétique la plus caractéristique du lymphome de la zone marginale splénique (LZMS). Une étude par hybridation génomique comparative de haute résolution a été conduite sur une série de 27 échantillons de LZMS afin de détecter des micro-remaniements du chromosome 7q. Une région commune de délétion (RCD) de 10,6 Mb a été délimitée sur le chromosome 7q. De plus, une microdélétion somatique du gène AHCYL2 (S-adenosyl-homocystéine hydrolase-like 2) a été détectée au sein de la RCD, définissant la plus petite RCD connue sur le chromosome 7q32 dans le SMZL et l'anomalie la plus fréquente de notre série (10/27, 37%). Bien que le séquençage du gène AHCYL2 n'a pas mis en évidence de mutation somatique, la délétion monoallélique du gène AHCYL2 est corrélée à la sous-expression de transcrits du gène AHCYL2 indiquant une haplo-insuffisance. La fonction précise de AHCYL2 reste inconnue, mais certaines données suggèrent que les protéines de type AHCYL peuvent réguler l'activité de l'enzyme AHCY (Sadénosyl- homocystéine hydrolase) et par conséquent affecter les mécanismes de transméthylation. En outre, nous avons identifié, pour la première fois dans le LZMS, une mutation R882H du gène DNMT3A (1/27, 3,7%) impliqué également dans les processus de méthylation. Ces résultats suggèrent que la dérégulation des voies métaboliques impliquées dans la méthylation peut jouer un rôle crucial dans la pathogenèse du LZMS / The chromosome 7q deletion is the most characteristic alteration in splenic marginal zone lymphoma (SMZL). High-resolution genome-focused approach was performed on 27 SMZL samples to identify submicroscopic genetic alterations on chromosome 7q. A 10.6 Mb-length common deleted region (CDR) of chromosome 7q was precisely delineated and a somatic microdeletion of the S-adenosyl-homocysteine hydrolase-like 2 (AHCYL2) gene was further detected within the CDR, defining the most frequent finding in this series (10/27, 37%) and the smallest CDR on chromosome 7q32. Although the sequencing of AHCYL2 gene did not show any evidence of somatic mutation, the monoallelic AHCYL2 gene deletion was directly correlated with underexpression of AHCYL2 transcripts, indicating a typical pattern of haploinsufficiency. The precise role of AHCYL2 remains unknown, but some data suggest that the AHCY-like proteins may regulate the activity of AHCY (S adenosylhomocysteine hydrolase) and consequently may affect the methylation metabolism. In addition, we report on a DNMT3A-R882H mutation (1/27, 3.7%) for the first time in SMZL. These findings suggest that methylation pathway dysfunction may play a crucial role in the pathogenesis of SMZL

Acute myeloid leukemia (AML) is a malignancy of the hematopoietic system caused by somatic mutations that accumulate in hematopoietic stem and progenitor cells. The cells are thereby transformed into leukemic stem cells (LSCs), which cannot be efficiently eliminated with the standard chemotherapy treatment. Thus, LSCs pose a risk of relapse for AML patients. There- fore, identification and characterization of LSCs is a major challenge in the field of AML research. Through next generation sequencing approaches the mutational spectrum of AML cells has been established and a continuous effort is being made to resolve the order of mutation acquisition and their functional consequences. In the subgroup of AML patients that bear a mutation in Nucleophosmin 1 (NPM1 ), a mutation in DNA-methyltransferase 3 A (DNMT3A) has been often found as a co-occurring event. Evidence suggests that this mutation arises early in leukemogene- sis and marks leukemic progenitors and stem cells. However, the functional consequences of this mutation are far from being understood. In this thesis work, I set out to unravel novel functional dependencies of the DNMT3A-mutant AML cells that can be exploited for therapeutic purposes. To nominate genes that are essential for the survival of primary AML cells, I performed a func- tional RNA interference-mediated drop out screen in 38 DNMT3A- and NPM1-mutant AML patient lines. The patients in this cohort were divided into two groups, based on the treatment outcome: an early relapse (ER) group and a long term remission (LTR) group. To nominate can- didate genes in each group, I have selected 12 screens with the highest data quality and performed a differential bioinformatic analysis. The analysis yielded 7 potential candidates, from which I initially validated three: Glucocorticoid modulatory element binding protein 1 (GMEB1), Mouse double minute 4 (MDM4) – both shared between the ER and the LTR groups – and Thioredoxin domain containing protein 9 (TXNDC9 ), which scored only in the ER group. Additional rounds of validation nominated MDM4 as the strongest candidate. To investigate the role of MDM4 in LSCs, I knocked it down in three patient samples and performed the long-term culture-initiating cell assay. However, the number of progenitor colonies that formed by the end of the assay was not enough for a statistical evaluation, probably due to the low frequency of long-term culture- initiating cells in the samples. Therefore, no conclusion regarding the functional dependency of LSCs on MDM4 could be made. However, a recent study suggested that loss of MDM4 causes cell cycle arrest and induces apoptosis in leukemic cell lines and primary cells, including progenitor populations, confirming the findings of this thesis. Nevertheless, the question about the role of MDM4 in NPM1 -mutant AML cells remains open. The NPM1 involvement in the p14Arf-MDM2- p53 pathway and the deregulation of this pathway caused by the NPM1 mutation indicate that MDM4 might poses special functions in NPM1 -mutant AML. Therefore, it should be investigated if MDM4 is a particularly suitable therapeutic target in AML with NPM1 mutation.

Introdução: A Leucemia Mielóide Aguda (LMA) é uma neoplasia complexa e heterogênea do tecido hematopoético, causada por mutações, desregulação da expressão gênica e modificações epigenéticas. Vários marcadores moleculares têm sido descritos para LMA, auxiliando a estratificação dos pacientes em grupos de risco. Recentemente, mutações em DNMT3A foram identificadas em 22.1% dos pacientes com LMA, estando independentemente associadas com pior prognóstico. Objetivos: Determinar a freqüência de mutações somáticas no gene DNMT3A e principais translocações cromossômicas em uma amostra de pacientes com LMA, correlacionando com dados clínicos Métodos: Foram pesquisadas, em 82 amostras de medula óssea de portadores de LMA atendidos no Hospital de Clínicas de Porto Alegre, RS, Brasil, para mutações somáticas no gene DNMT3A por seqüenciamento e principais transcritos de fusão por RT-PCR. Resultados: A freqüência de mutações no gene DNMT3A foi de 8%(6) sendo 3 do tipo R882H. A freqüência relativa dos transcritos de fusão oriundos das translocações t(8;21), t(15;17), t(9;11) e inv16, respectivamente foram: 6,1%(5), 14,6% (12), 0%(0) e 2,4%(2). Conclusão: A descoberta de mutações recorrentes no gene DNMT3A e sua possível implicação prognóstica pode ser um instrumento valioso para a tomada de decisões terapêuticas. Que nos conste, este é o primeiro estudo sobre a presença de mutações somáticas do gene DNMT3A em portadores de LMA no Brasil. Embora em uma amostra relativamente pequena, a freqüência encontrada destas mutações foi inferior à relatada para pacientes caucasianos, sugerindo uma possível variação etnico-geográfica. / Introduction: Acute Myeloid Leukemia (AML) is a complex and heterogeneous neoplasm hematopoietic tissue, caused by mutations, dysregulation of gene expression and epigenetic modifications. Several molecular markers have been described for AML, helping to classify patients into risk groups. Recently, mutations in DNMT3A were identified in 22.1% of patients with AML and these independently associated with poor prognosis. Aims: Determine the frequency of somatic mutations in the gene DNMT3A and major chromosomal translocations in a sample of patients with AML, correlating with clinical data. Methods: We investigated in 82 samples of bone marrow or peripheral blood of patients with AML treated at the Hospital de Clínicas de Porto Alegre, Brazil, for somatic mutations in DNMT3A gene by sequencing and major fusion transcripts by RT-PCR. Results: The frequency of mutations in the DNMT3A gene was 8%(6) 3 being type R882H. The relative frequency of fusion transcripts arising from translocation t(8;21), t(15;17), t(9;11) and inv16, respectively were: 6,1%(5), 14,6% (12), 0%(0) and 2,4%(2). Conclusion: The discovery of recurrent mutations in the DNMT3A gene and its possible prognostic implications can be a valuable tool for making treatment decisions. From what we have recorded, this is the first study on the presence of somatic mutations of the DNMT3A gene in patients with AML in Brazil. Although in a relatively small sample, the frequency of these mutations was found lower than that reported for Caucasian patients and similar to that observed in Asian patients, suggesting a possible ethno-geographic variation.

Introdução: A Leucemia Mielóide Aguda (LMA) é uma neoplasia complexa e heterogênea do tecido hematopoético, causada por mutações, desregulação da expressão gênica e modificações epigenéticas. Vários marcadores moleculares têm sido descritos para LMA, auxiliando a estratificação dos pacientes em grupos de risco. Recentemente, mutações em DNMT3A foram identificadas em 22.1% dos pacientes com LMA, estando independentemente associadas com pior prognóstico. Objetivos: Determinar a freqüência de mutações somáticas no gene DNMT3A e principais translocações cromossômicas em uma amostra de pacientes com LMA, correlacionando com dados clínicos Métodos: Foram pesquisadas, em 82 amostras de medula óssea de portadores de LMA atendidos no Hospital de Clínicas de Porto Alegre, RS, Brasil, para mutações somáticas no gene DNMT3A por seqüenciamento e principais transcritos de fusão por RT-PCR. Resultados: A freqüência de mutações no gene DNMT3A foi de 8%(6) sendo 3 do tipo R882H. A freqüência relativa dos transcritos de fusão oriundos das translocações t(8;21), t(15;17), t(9;11) e inv16, respectivamente foram: 6,1%(5), 14,6% (12), 0%(0) e 2,4%(2). Conclusão: A descoberta de mutações recorrentes no gene DNMT3A e sua possível implicação prognóstica pode ser um instrumento valioso para a tomada de decisões terapêuticas. Que nos conste, este é o primeiro estudo sobre a presença de mutações somáticas do gene DNMT3A em portadores de LMA no Brasil. Embora em uma amostra relativamente pequena, a freqüência encontrada destas mutações foi inferior à relatada para pacientes caucasianos, sugerindo uma possível variação etnico-geográfica. / Introduction: Acute Myeloid Leukemia (AML) is a complex and heterogeneous neoplasm hematopoietic tissue, caused by mutations, dysregulation of gene expression and epigenetic modifications. Several molecular markers have been described for AML, helping to classify patients into risk groups. Recently, mutations in DNMT3A were identified in 22.1% of patients with AML and these independently associated with poor prognosis. Aims: Determine the frequency of somatic mutations in the gene DNMT3A and major chromosomal translocations in a sample of patients with AML, correlating with clinical data. Methods: We investigated in 82 samples of bone marrow or peripheral blood of patients with AML treated at the Hospital de Clínicas de Porto Alegre, Brazil, for somatic mutations in DNMT3A gene by sequencing and major fusion transcripts by RT-PCR. Results: The frequency of mutations in the DNMT3A gene was 8%(6) 3 being type R882H. The relative frequency of fusion transcripts arising from translocation t(8;21), t(15;17), t(9;11) and inv16, respectively were: 6,1%(5), 14,6% (12), 0%(0) and 2,4%(2). Conclusion: The discovery of recurrent mutations in the DNMT3A gene and its possible prognostic implications can be a valuable tool for making treatment decisions. From what we have recorded, this is the first study on the presence of somatic mutations of the DNMT3A gene in patients with AML in Brazil. Although in a relatively small sample, the frequency of these mutations was found lower than that reported for Caucasian patients and similar to that observed in Asian patients, suggesting a possible ethno-geographic variation.

Introdução: A Leucemia Mielóide Aguda (LMA) é uma neoplasia complexa e heterogênea do tecido hematopoético, causada por mutações, desregulação da expressão gênica e modificações epigenéticas. Vários marcadores moleculares têm sido descritos para LMA, auxiliando a estratificação dos pacientes em grupos de risco. Recentemente, mutações em DNMT3A foram identificadas em 22.1% dos pacientes com LMA, estando independentemente associadas com pior prognóstico. Objetivos: Determinar a freqüência de mutações somáticas no gene DNMT3A e principais translocações cromossômicas em uma amostra de pacientes com LMA, correlacionando com dados clínicos Métodos: Foram pesquisadas, em 82 amostras de medula óssea de portadores de LMA atendidos no Hospital de Clínicas de Porto Alegre, RS, Brasil, para mutações somáticas no gene DNMT3A por seqüenciamento e principais transcritos de fusão por RT-PCR. Resultados: A freqüência de mutações no gene DNMT3A foi de 8%(6) sendo 3 do tipo R882H. A freqüência relativa dos transcritos de fusão oriundos das translocações t(8;21), t(15;17), t(9;11) e inv16, respectivamente foram: 6,1%(5), 14,6% (12), 0%(0) e 2,4%(2). Conclusão: A descoberta de mutações recorrentes no gene DNMT3A e sua possível implicação prognóstica pode ser um instrumento valioso para a tomada de decisões terapêuticas. Que nos conste, este é o primeiro estudo sobre a presença de mutações somáticas do gene DNMT3A em portadores de LMA no Brasil. Embora em uma amostra relativamente pequena, a freqüência encontrada destas mutações foi inferior à relatada para pacientes caucasianos, sugerindo uma possível variação etnico-geográfica. / Introduction: Acute Myeloid Leukemia (AML) is a complex and heterogeneous neoplasm hematopoietic tissue, caused by mutations, dysregulation of gene expression and epigenetic modifications. Several molecular markers have been described for AML, helping to classify patients into risk groups. Recently, mutations in DNMT3A were identified in 22.1% of patients with AML and these independently associated with poor prognosis. Aims: Determine the frequency of somatic mutations in the gene DNMT3A and major chromosomal translocations in a sample of patients with AML, correlating with clinical data. Methods: We investigated in 82 samples of bone marrow or peripheral blood of patients with AML treated at the Hospital de Clínicas de Porto Alegre, Brazil, for somatic mutations in DNMT3A gene by sequencing and major fusion transcripts by RT-PCR. Results: The frequency of mutations in the DNMT3A gene was 8%(6) 3 being type R882H. The relative frequency of fusion transcripts arising from translocation t(8;21), t(15;17), t(9;11) and inv16, respectively were: 6,1%(5), 14,6% (12), 0%(0) and 2,4%(2). Conclusion: The discovery of recurrent mutations in the DNMT3A gene and its possible prognostic implications can be a valuable tool for making treatment decisions. From what we have recorded, this is the first study on the presence of somatic mutations of the DNMT3A gene in patients with AML in Brazil. Although in a relatively small sample, the frequency of these mutations was found lower than that reported for Caucasian patients and similar to that observed in Asian patients, suggesting a possible ethno-geographic variation.