Acute Myeloid Leukemia (AML) is a predominant acute leukemia among adults, characterized by accumulation of malignantly transformed immature myeloid precursors. A very attractive way to treat myeloid leukemia, which is now called ‘differentiation therapy’, was proposed as in vitro studies have shown that a variety of agents stimulate differentiation of the cell lines isolated from leukemic patients. One of the differentiation-inducing agents, all-trans retinoic acid (ATRA), which can induce granulocytic differentiation in myeloid leukemic cell lines, has been introduced into clinics to treat patients with acute promyelocytic leukemia (APL) in which a PML-RARA fusion protein is generated by a t(15;17)(q22;q12) chromosomal translocation. Because differentiation therapy using ATRA has significantly improved prognosis for patients with APL, many efforts have been made to find alternative differentiating agents. Since 1,25-dihydroxyvitamin D₃ (1,25D) is capable of inducing in vitro monocyte/macrophage differentiation of myeloid leukemic cells, clinical trials have been performed to estimate its potential to treat patients with AML or myelodysplastic syndrome (MDS). Unfortunately therapeutic concentrations of 1,25D can induce potentially fatal systemic hypercalcemia, thus limiting clinical utility of that compound. Attempts to overcome this problem have focused on the synthesis of 1,25D analogs (VDAs) which retain differentiation inducing potential, but lack its hypercalcemic effects. This review aims to discuss current problems and potential solutions in differentiation therapy of AML.

Human fibroblast growth factor 1 (FGF-1) is one of the best characterized members of the FGF superfamily. FGF-1 is a powerful mitogen exhibiting strong action on numerous different cell types. It plays a role in various stages of development and morphogenesis, as well as in angiogenesis and wound healing processes. Engineering of FGFs can bring many advantages. Design and construction of different mutants can contribute to a better understanding of the mechanism of action of protein growth factors. Moreover, application of FGFs as recombinant polypeptides in the treatment of wound and fracture healing, cardiovascular diseases and neurodegenerative diseases seems to be a rational medical approach. However, low thermal stability and high sensitivity to proteases limit the potential pharmaceutical use of wild-type FGFs. Thus, advanced protein design techniques and recombinant protein production can help to obtain new variants of FGFs with radically increased thermodynamic stability, prolonged half-life and improved proteolytic resistance. Such studies can provide a good starting point to convert short-lived and/or sensitive growth factors to effective therapeutic proteins.