– Metformin induces reactive oxygen species (ROS) and ferroptotic cell death in primary AML samples ex vivo, with greatest effect in cases having disrupted lipid metabolism (notably IDH2- and FLT3-mutant disease).
– Lipidomic remodeling with increased triglycerides and polyunsaturated fatty acids (PUFAs), upregulation of lipid-droplet genes including DGAT1, and CD36-mediated uptake are key determinants of metformin sensitivity.
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