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Moreover, this chromatin-condensed state supports AML cell resistance by dampening apoptotic pathways, enhancing DNA repair mechanisms, and reinforcing drug-efflux and survival circuitsthus enabling neoplastic clones to evade cytotoxic and targeted therapies ( Histone deacetylation, mediated primarily by HDACs and sirtuins, represses transcription by compacting chromatin, thereby silencing tumor-suppressor genes and differentiation programs in AML cells

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F.ZhangS.ZhaoF.LiY.et al (2008)

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