Objective. This study aimed to investigate the mechanisms of action of WEB-2170, an inverse agonist of platelet-activating factor receptor, capable of inducing apoptosis in human acute myelogenous leukemia (AML) cells. Material and Methods. Gene expression profiling followed by cytofluorimetric, morphologic, and biologic analyses were used to monitor WEB-2170 effects in AML cell lines (ie, NB4, KG1, NB4-MR4, THP1, and U937) and blasts from patients with different AML (M0LM5) subtypes. PTEN silencing with small interfering RNA was also performed. Results. We have demonstrated that drug-mediated cytostasis/apoptosis in NB4 cells is characterized by upregulation of cyclin G2, p21/WAF1, NIX, TNFLa, and PTEN expression, and downregulation of cyclin D2 and BCL2 expression. We observed an increase in PTEN protein accompanied by a decrease in phospho-extracellular signal-regulated kinase 2 (ERK2) and phospho-AKT, and by forkhead box O3a (FOXO3a) cytoplasmic-nuclear translocation; the mitochondrial cytochrome C release and PARP cleavage marked the late apoptotic steps. We have found that WEB-2170 triggered apoptosis in NB4, KG1, and NB4-MR4 cells where PTEN was expressed, but not in THP1 and U937 cells where PTEN was absent. Finally, we show that PTEN silencing in NB4 cells by PTEN-specific small interfering RNA resulted in a significant reduction of drug-induced apoptosis. Conclusion. We demonstrated that WEB-2170 is a powerful antileukemic agent with interesting translational opportunities to treat AML and described mechanisms of drug-induced intrinsic and extrinsic apoptosis both in AML cell lines and blasts from AML patients by addressing PTEN as the master regulator of the whole process. Ó 2009 ISEH -Society for Hematology and Stem Cells. Published by Elsevier Inc.Acute promyelocytic leukemia (APL) with t(15;17) chromosomal translocation is a subtype of acute myelogeneous leukemia (AML) that can be successfully cured by alltrans-retinoic acid (ATRA) targeted therapy toward the PML/RARa fusion protein [1]. ATRA can also be used in combination with other agents to treat elderly AML patients carrying the nucleophosmin-1 mutation [2]. This approach, however, is not effective on ATRA-resistant APL forms and other AML (non-APL) subtypes [3], which are refractory to ATRA-induced differentiation [4]. Therefore, the current treatment for the bulk of the other AML subtypes still consists of high-dose chemotherapy with potential lifethreatening toxicity and acquired drug resistance [5].Inhibitors of histone deacetylases [6] and DNA demethylating agents [7,8] 2009;37:1176-1185 [9], thus providing additional tools for cancer therapy [10]. Indeed, epigenetic modulators are functional to set up an environment permissive for cell differentiation and/or apoptosis, but may not always be sufficient themselves to trigger these processes without the cooperation of other proactive signals. It is of great interest, therefore, to identify and characterize new agents capable of inducing cytostasis, differentiation, and apoptosis in AML...