Evidence map›Paper›PMID 42173855›Full record

ArticleNature communications2026

Initial leukemic epigenomic state determines hypomethylating agent response.

Aparna Gopal, Derek Tam, Franziska Mey, Diana Lin, Christina May, Jihong Jiang, Joshua Bridgers, Brett Caswell, Kieran O'Neill, Frederick S Vizeacoumar and 14 more

Abstract read
In one paragraph

Article in Nature communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Aparna Gopal *BC Cancer Research Institute, Vancouver, British Columbia, Canada.
Derek Tam *BC Cancer Research Institute, Vancouver, British Columbia, Canada.
Franziska MeyBC Cancer Research Institute, Vancouver, British Columbia, Canada.ORCID http://orcid.org/0009-0000-3856-7123
Diana LinBC Cancer Research Institute, Vancouver, British Columbia, Canada.ORCID http://orcid.org/0000-0001-9645-3247
Christina MayBC Cancer Research Institute, Vancouver, British Columbia, Canada.ORCID http://orcid.org/0000-0003-2691-505X
Jihong JiangBC Cancer Research Institute, Vancouver, British Columbia, Canada.
Joshua BridgersBC Cancer Research Institute, Vancouver, British Columbia, Canada.
Brett CaswellBC Cancer Research Institute, Vancouver, British Columbia, Canada.
Kieran O'NeillBC Cancer Research Institute, Vancouver, British Columbia, Canada.
Frederick S VizeacoumarCancer Cluster, College of Medicine, University of Saskatchewan, Saskatoon, Canada.ORCID http://orcid.org/0000-0002-4676-2911
Mackenzie MacAuleyCancer Cluster, College of Medicine, University of Saskatchewan, Saskatoon, Canada.
Emilie HaniakBC Cancer Research Institute, Vancouver, British Columbia, Canada.
Charles CraddockCentre for Clinical Haematology, Queen Elizabeth Hospital, University of Birmingham, Birmingham, UK.ORCID http://orcid.org/0000-0001-5041-6678
Paresh VyasMRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0003-3931-0914
Luca MalcovatiDepartment of Molecular Medicine, University of Pavia, Pavia, Italy.ORCID http://orcid.org/0000-0002-1460-1611
Rena BucksteinSunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Michelle MoksaMichael Smith Laboratories, Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada.
Martin HirstMichael Smith Laboratories, Department of Microbiology and Immunology, University of British Columbia, Vancouver, British Columbia, Canada.ORCID http://orcid.org/0000-0001-9136-9054
Franco J VizeacoumarDepartment of Oncology, College of Medicine, University of Saskatchewan, Saskatoon, Canada.ORCID http://orcid.org/0000-0002-6452-5207
Nadia MedvedevDepartment of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Michael HeuserUniversity Hospital Halle (Saale), Department of Internal Medicine IV, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
Ryan J StubbinsBC Cancer Research Institute, Vancouver, British Columbia, Canada.
Yu DengBC Cancer Research Institute, Vancouver, British Columbia, Canada.
Aly KarsanBC Cancer Research Institute, Vancouver, British Columbia, Canada. akarsan@bccrc.ca.ORCID http://orcid.org/0000-0001-6753-892X

Funding

Associazione Italiana per la Ricerca sul Cancro (Italian Association for Cancer Research) 31013Canadian Cancer Society Research Institute (Société Canadienne du Cancer) 705811Terry Fox Research Institute (Institut de Recherche Terry Fox) 1074V Foundation for Cancer Research (V Foundation) T2024-016
6 · The paper itself

Abstract

Hypomethylating agents (HMAs) are a mainstay of therapy for myeloid cancers, but genetic biomarkers do not predict who will respond to treatment. Using a variety of single-cell sequencing approaches to define the epigenomic state of responder and nonresponder leukemic cells, we demonstrate that leukemic stem cells (LSC) exist in at least two different epigenomic states: a hematopoietic stem cell (HSC)-or multipotent progenitor (MPP)-like state that is sensitive to HMAs, independent of genetic mutations, or a lymphoid-primed MPP (LMPP)-like nonresponder state. Hypomethylation and chromatin accessibility at ZNF143- and CTCF-binding sites results in activation of HOXB4, which defines the HSC/MPP-like state and HMA-sensitivity. Our study provides evidence that the epigenomic state of the LSC is a major determinant of response to HMAs, and demonstrates that a routine clinical assay can identify patients who will respond.

Indexed as

DNA MethylationEpigenesis, GeneticLeukemiaNeoplastic Stem CellsAnimalsCCCTC-Binding FactorChromatinEpigenomicsHematopoietic Stem CellsHomeodomain ProteinsHumansMultipotent Stem CellsTrans-ActivatorsTranscription FactorsCCCTC-Binding FactorChromatinCTCF protein, humanHomeodomain ProteinsTrans-ActivatorsTranscription Factors

Identifiers

PMID42173855
PMCPMC13388667

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.