IntroductionAcute myelogenous leukemia (AML) is a clonal disorder of hematopoietic progenitor cells that is characterized by accumulation of blasts with an unrestrained proliferative capacity and a block at various stages of myeloid differentiation. 1 The development of AML involves a multistep process with the acquisition of alterations in genes that confer a proliferative advantage or affect differentiation. 2 Allogeneic bone marrow transplantation and therapy with cytosine arabinoside and daunorubicin have had a significant effect on long-term survival of AML patients younger than age 60. However, patients older than age 60 and those with secondary AML or a previous myelodysplastic syndrome have a poor prognosis. The concept that AML occurs as a result of a block in maturation has led to therapeutic approaches based on the use of agents that induce terminal AML cell differentiation. However, such strategies have been limited, in terms of effectiveness, to the treatment of acute promyelocytic leukemia (APL). For example, all-trans retinoic acid (ATRA) and arsenic trioxide induce differentiation of APL cells and have had a marked effect on the treatment of this disease. 3 Other studies have provided support for the involvement of reactive oxygen species (ROS) in the regulation of AML cell survival and induction of myeloid cell differentiation. 4 In this context, AML cell self-renewal is decreased by agents that increase ROS levels. [5][6][7] Moreover, differentiation of AML cells has been associated with increases in ROS. 8 These findings have suggested that targeting redox balance may overcome the block in terminal AML cell differentiation.The MUC1 heterodimeric protein is aberrantly expressed in blasts from patients with AML. 9,10 MUC1 includes an extracellular N-terminal subunit (MUC1-N) that has the structural characteristics of mucins and is tethered to the cell surface in a complex with a C-terminal transmembrane subunit (MUC1-C). 11 MUC1-C consists of a 58-amino acid extracellular domain, a transmembrane domain, and a 72-amino acid cytoplasmic domain. 11 In transformed cells with up-regulation of MUC1 expression, the MUC1-C subunit accumulates in the cytoplasm and is targeted to the nucleus and mitochondria. 11 The MUC1-C cytoplasmic domain is phosphorylated by c-Src and certain receptor tyrosine kinases, and interacts with effectors, such as -catenin and NF-B, that have been linked to transformation. 11 Notably in this regard, the MUC1-C cytoplasmic domain is sufficient to induce anchorage-independent growth and tumorigenicity. 12 Overexpression of MUC1-C also blocks death induced in the response to DNA damage, ROS, and other forms of stress. 11,13,14 Targeting of MUC1-C to the nucleus and mitochondria, and thereby its transforming function, is dependent on the formation of oligomers through a CQC motif in the MUC1-C cytoplasmic domain. 11,15 These observations led to the development of cell-penetrating peptides that bind to the CQC motif and block MUC1-C oligomerization and function. 16 Moreover, trea...