The impact of the chromatin binding DEK protein in hematopoiesis and acute myeloid leukemia.

Hematopoiesis is an exquisitely regulated process of cellular differentiation to create diverse cell types of the blood. Genetic mutations, or aberrant regulation of gene transcription, can interrupt normal hematopoiesis. This can have dire pathological consequences, including acute myeloid leukemia (AML), in which generation of the myeloid lineage of differentiated cells is interrupted. In this literature review, we discuss how the chromatin remodeling DEK protein can control hematopoietic stem cell quiescence, hematopoietic progenitor cell proliferation, and myelopoiesis. We further discuss the oncogenic consequences of the t(6;9) chromosomal translocation, which creates the DEK-NUP214 (aka: DEK-CAN) fusion gene, during the pathogenesis of AML. Combined, the literature indicates that DEK is crucial for maintaining homeostasis of hematopoietic stem and progenitor cells, including myeloid progenitors.

Exploring the Impact of Experiences with Everyday and Major Discrimination and HIV-Related Stigma on Engagement in HIV Care Among Older African Americans Living with HIV.

OBJECTIVES: The purpose of this pilot study was to explore the effect of HIV-related stigma and everyday major experiences of discrimination on medication and clinic visit adherence among older African Americans living with HIV in Ohio. METHODS: We collected data from 53 individuals who were living with HIV in Ohio, ≥ 50 years of age, and who identified as Black or African American. We conducted logistic regression models to examine the impact of HIV-related stigma and experiences of discrimination on medication and visit adherence. Each model controlled for age, time since diagnosis, and sexual orientation. RESULTS: The average age was 53.6 ± 2.1 years and 94.3% were men. Almost half (49.1%) of the participants reported poor medication adherence and almost a third (31.4%) reported poor visit adherence. HIV-related stigma (adjusted odds ratio (aOR) = 1.39; 95% confidence interval (CI) = 1.02-1.89) and major experiences of discrimination (aOR = 1.70; 95% CI = 1.11-2.60) were associated with a greater odds of poor medication adherence. Additionally, major experiences of discrimination were associated with a threefold increase in the odds of poor visit adherence (aOR = 3.24; 95% CI = 1.38-7.64). CONCLUSIONS: HIV-related stigma and major experiences of discrimination impede optimal medication and HIV clinic visit adherence for older African Americans living with HIV. To reduce the impact of stigma and discrimination on HIV care engagement, our first step must be in understanding how intersecting forms of stigma and discrimination impact engagement among older African Americans living with HIV.