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. Author manuscript; available in PMC: 2021 Nov 24.
Published in final edited form as: Exp Hematol. 2021 Jul 21;100:1–11. doi: 10.1016/j.exphem.2021.07.002

Figure 2.

Figure 2.

Waddington landscape depicting the impact of MLL fusion oncoproteins and extrinsic factors on leukemia lineage. (A) The expanded progenitor cell diagram reveals myeloid- or lymphoid-promoting signals (filled arrows) promoting transcription factors (ovals) acting on lineage-directing enhancers (filled rectangles) to maintain exclusive lineage identity. Red double-headed arrows indicate the latent myeloid potential of transformed B-ALL which can overcome the activation energy to lose B-cell characteristics and gain myeloid identity. (B) Lineage switching on CD19-directed therapy (green crescent) as influenced by direct killing of the CD19+ B-ALL and/or impact of the immunotherapy and the niche on lineage decisions within the remaining B-ALL cells.