Concurrent loss of Ezh2 and Tet2 cooperates in the pathogenesis of myelodysplastic disorders

J Exp Med. 2013 Nov 18;210(12):2627-39. doi: 10.1084/jem.20131144. Epub 2013 Nov 11.


Polycomb group (PcG) proteins are essential regulators of hematopoietic stem cells. Recent extensive mutation analyses of the myeloid malignancies have revealed that inactivating somatic mutations in PcG genes such as EZH2 and ASXL1 occur frequently in patients with myelodysplastic disorders including myelodysplastic syndromes (MDSs) and MDS/myeloproliferative neoplasm (MPN) overlap disorders (MDS/MPN). In our patient cohort, EZH2 mutations were also found and often coincided with tet methylcytosine dioxygenase 2 (TET2) mutations. Consistent with these findings, deletion of Ezh2 alone was enough to induce MDS/MPN-like diseases in mice. Furthermore, concurrent depletion of Ezh2 and Tet2 established more advanced myelodysplasia and markedly accelerated the development of myelodysplastic disorders including both MDS and MDS/MPN. Comprehensive genome-wide analyses in hematopoietic progenitor cells revealed that upon deletion of Ezh2, key developmental regulator genes were kept transcriptionally repressed, suggesting compensation by Ezh1, whereas a cohort of oncogenic direct and indirect polycomb targets became derepressed. Our findings provide the first evidence of the tumor suppressor function of EZH2 in myeloid malignancies and highlight the cooperative effect of concurrent gene mutations in the pathogenesis of myelodysplastic disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cohort Studies
  • DNA-Binding Proteins / deficiency
  • DNA-Binding Proteins / genetics*
  • Dioxygenases
  • Disease Models, Animal
  • Enhancer of Zeste Homolog 2 Protein
  • Genome-Wide Association Study
  • Hematopoiesis / genetics
  • Hematopoietic Stem Cells / metabolism
  • Humans
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Mutation
  • Myelodysplastic Syndromes / etiology*
  • Myelodysplastic Syndromes / genetics
  • Myeloproliferative Disorders / genetics
  • Polycomb Repressive Complex 2 / deficiency
  • Polycomb Repressive Complex 2 / genetics*
  • Proto-Oncogene Proteins / deficiency
  • Proto-Oncogene Proteins / genetics*
  • Tumor Suppressor Proteins / genetics


  • DNA-Binding Proteins
  • Proto-Oncogene Proteins
  • Tumor Suppressor Proteins
  • Dioxygenases
  • TET2 protein, human
  • Tet2 protein, mouse
  • EZH2 protein, human
  • Enhancer of Zeste Homolog 2 Protein
  • Ezh1 protein, mouse
  • Ezh2 protein, mouse
  • Polycomb Repressive Complex 2