Lactate utilization facilitates BETi resistance in AML patient myeloblasts. (A) NSGS mice were engrafted with BETi-resistant AML myeloblasts (GI50 BETi = 2.5 μM). Mice were treated with vehicle control, BETi (50 mg/kg) and/or oxamate (200 mg/kg), and then sacrificed. (B) Spleens were weighed, and tumor burden assessed by chimerism analysis by quantifying hCD45+hCD33+ cells using (C) flow cytometry and (D) immunohistochemistry (hCD45, scale bar = 50 μm). Each point represents a single mouse (mock, n = 5; BETi or oxamate, n = 4 or 5; BETi+oxamate, n = 3 or 4). (B) One- or (C) two-way ANOVA with Tukey multiple comparisons test (*P ≤ 0.05, ns = not significant).