Fig. 1. Schematic illustration of leukemia-induced alterations of niches and their clinical significance. LSC clones developed in bone marrow can induce transcriptional reprogramming of mesenchymal cells and the remodeling of the niche towards a loss of M-progenitors and maturation into osteoblastic cells. Altered niche can provide a distinctive cross-talk to normal HSCs and LSCs in a manner that can selectively suppress normal HSCs (−) but maintain LSCs (＋), leading to the dominance of leukemia cells over normal hematopoietic cells. The difference in stromal remodeling at the initial diagnosis is associated with heterogeneity in clinical prognosis after the treatment. Thus, stromal remodeling as a parameter that can influence leukemogenic activity and subsequent clinical course can serve as a prognostic marker in AML.