(A) viability of 41 PDX lines relative to controls 24 h after exposure to 100 nM birinapant. (B) Birinapant sensitivity of 41 PDX lines (% control after treatment with 100 nM) stratified by B and T lineage ALL. (C) Birinapant sensitivity in BCP-ALL xenografts stratified by subtype. (D) Percentage of viable primary ALL cells (annexin V-/7AAD–) cells after 24 h treatment with 100 nM birinapant. (E) sensitive and resistant BCP-ALL xenografts were incubated with birinapant (0.1 and 1 μM respectively), QVD (10 μM), Nec1 (10 μM), or birinapant + QVD/Nec1 for 24 h. (F) protein levels of cIAP1, cIAP2, XIAP, RIP1, total/cleaved caspase 8 (Cl.caspase 8) and total/cleaved caspase 3 were analyzed by immunoblotting in three Ph-like BCP-ALL xenografts (PAKRSL, PALLSD and PAMDRM) and 2 Ph+ BCP-ALL xenografts (ALL-4 and ALL-55) after treatment with 1 μM birinapant. Data in A and E represent the mean ± SEM from ≥ 3 biological replicates, while data in D are from 3 technical replicates.