T-cell
malignancies, including T-cell
acute lymphoblastic leukemia (
T-ALL) and
T-cell lymphoma (TCL), are characterized by inferior treatment effects, high heterogeneity, poor prognosis, and a lack of specific therapeutic targets and drugs to improve outcome.
Disulfiram (DSF) is a drug used to clinically control
alcoholism that has recently been shown to be cytotoxic for multiple
cancers. However, the underlying effects and mechanisms of DFS treatment in patients with T-cell
malignancies are not well characterized. In this study, we report that DSF promotes apoptosis and inhibits the proliferation of malignant T-cell cell lines and primary
T-ALL cells. We provide evidence that DSF exerts anticancer activity in T-cell
malignancies by targeting the NPL4-mediated
ubiquitin-
proteasome pathway. Notably, high expression of NPL4 and 2
ubiquitin-
proteasome pathway genes,
anaphase-promoting complex subunit 1 (
ANAPC1) and
proteasome 26S subunit
ubiquitin receptor, non-
ATPase 2 (PSMD2), was significantly associated with unfavorable overall survival (OS) for patients with TCL and
T-ALL (p < 0.05). More importantly, the weighted combination of NPL4,
ANAPC1, and PSMD2 could visually display the 1-, 3-, and 5-year OS rates for patients with T-cell
malignancies in a nomogram model and facilitate risk stratification. Specifically, risk stratification was an independent predictor of OS for patients with T-cell
malignancies. In conclusion, DSF might induce apoptosis and inhibit the proliferation of malignant T-cells via the NPL4-mediated
ubiquitin-
proteasome pathway and offer a potential therapeutic option for T-cell
malignancies.