iwAL 2026 | Disrupting leukemia stem-cell self-renewal versus differentiation therapy in AML
Stephen Nimer, MD, Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL, discusses how disrupting leukemia stem cell self-renewal and differentiation therapy may target similar biological events in acute myeloid leukemia (AML). Dr Nimer explains that epigenetic therapy can change a cell’s identity, making it more susceptible to being killed, and notes that quiescent stem cells can resist many forms of therapy, so moving them out of quiescence through differentiation is important. This interview took place at the 8th International Workshop on Acute Leukemias (iwAL 2026), held in Boston, MA.
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Transcript
I think it’s not overlapping, but I do think that they’re targeting some very similar events. I mentioned the notion that stem cells can either divide and generate one or two more stem cells, which would maintain or expand the leukemia, or if you can differentiate them so they lose stem cell properties, then you can eliminate the leukemic stem cell. I’d also say epigenetic therapy is designed to change the identity of the cell...
I think it’s not overlapping, but I do think that they’re targeting some very similar events. I mentioned the notion that stem cells can either divide and generate one or two more stem cells, which would maintain or expand the leukemia, or if you can differentiate them so they lose stem cell properties, then you can eliminate the leukemic stem cell. I’d also say epigenetic therapy is designed to change the identity of the cell. So if you can use epigenetic therapy and confuse the cell so that it no longer thinks it’s a stem cell anymore it will divide, it will differentiate and divide, and so that differentiation now it loses its pluripotency and then it should naturally die or it should be more amenable to being killed. The other thing these early stem cells, early stem cells are quiescent. And quiescent cells tend to be able to resist almost any form of therapy, whether it be antibody-directed, targeted therapies. So getting cells out of quiescence is important. And by differentiating the cell from the stem cell, the cell will enter the cycle and be more killable.
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