File:AML1-ETO effects on p53 pathway..png

English: Figure 1. Overview of major interaction with tumor suppressor p14ARF and downstream effects of fusion protein AML1-ETO in M2 acute myeloid leukemia. Elimination of the tumor suppressor ARF gene is often seen in cancer cells. In adult M2 acute myeloblastic leukemia with maturation, ARF expression is suppressed via chromosome translocations that fuse AML1 or Runx1 to an ETO gene. The AML1 or Runx1 gene is in charge of activating transcription of the ARF gene while the ETO protein is involved in transcriptional repression. The AML1-ETO fusion protein ultimately causes transcriptional repression of the p14ARF gene, which deregulates the expression levels of Mdm2 and p53. The down regulation of ARF, increases Mdm2 levels due to the lack of regulation by the ARF gene. Unregulated, overexpressed Mdm2 will suppress p53 levels. The suppression of p53 levels is an anti-apoptotic mechanism for cancer cells to survive (Elagib, 2006, Weinberg, 2014).