Rearrangements of the MLL (ALL1) gene are very common in acute infant and therapy-associated leukemias. The rearrangements underlie the generation of MLL fusion proteins acting as potent oncogenes. Several most consistently up-regulated targets of MLL fusions, MEIS1, HOXA7, HOXA9, and HOXA10 are functionally related and have been implicated in other types of leukemias. Each of the four genes was knocked down separately in the human precursor B-cell leukemic line RS4;11 expressing MLL-AF4. The mutant and control cells were compared for engraftment in NOD/ SCID mice. Engraftment of all mutants into the bone marrow (BM) was impaired. Although homing was similar, colonization by the knockdown cells was slowed. Initially, both types of cells were confined to the trabecular area; this was followed by a rapid spread of the WT cells to the compact bone area, contrasted with a significantly slower process for the mutants. In vitro and in vivo BrdU incorporation experiments indicated reduced proliferation of the mutant cells. In addition, the CXCR4/SDF-1 axis was hampered, as evidenced by reduced migration toward an SDF-1 gradient and loss of SDF-1-augmented proliferation in culture. The very similar phenotype shared by all mutant lines implies that all four genes are involved and required for expansion of MLL-AF4 associated leukemic cells in mice, and down-regulation of any of them is not compensated by the others.leukemic cells' migration | bone marrow colonization of leukemic cells R earrangements of the MLL/ALL1 gene occur in 20% of acute lymphoblastic leukemias (ALL) and in 5-6% of acute myeloid leukemias (AML) (1, 2). A high percentage of ALLs with MLL rearrangement show biphenotypic traits. The epidemiology of MLL-associated leukemias is unique (3). They predominate infant acute leukemia, and account for the majority of therapy-related leukemias occurring in cancer patients treated with etoposide (VP-16) or doxorubicin (4). The very short latency of the disease (3, 4) and its aggressive nature suggest the involvement of a powerful oncogene. Most MLL rearrangements are due to reciprocal chromosome translocations that link MLL to any of >100 partner genes (5). This results in production of oncogenic MLL proteins, comprising the N-terminal MLL polypeptide fused in frame to the C-terminal fragment of a partner protein. The partner proteins most commonly found associated with MLL (AF4, AF9, ENL, AF10, ELL) are transcriptional elongation factors (6). Because these factors physically associate (6, 7), the function of the most common partner polypeptides within MLL fusion proteins appears to be the recruitment of the other elongation factors, and consequently the augmentation of target genes transcription (8)(9)(10)(11).Initial gene expression analysis of leukemic cells from ALL patients indicated up-regulation of HOXA9 and HOXA10 and their essential cofactor MEIS1 in cells with the t(4;11) chromosome translocation and MLL-AF4 (12). Subsequent gene expression profiling of leukemic cells with MLL rearrangements from patient...