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Item HOXA9 Reprograms the Enhancer Landscape to Promote Leukemogenesis(Elsevier, 2018-10-08) Sun, Yuqing; Zhou, Bo; Mao, Fengbiao; Xu, Jing; Miao, Hongzhi; Zou, Zhenhua; Khoa, Le Tran Phuc; Jang, Younghoon; Cai, Sheng; Witkin, Matthew; Koche, Richard; Ge, Kai; Dressler, Gregory; Levine, Ross L.; Armstrong, Scott A.; Dou, Yali; Hess, Jay L.; Pathology and Laboratory Medicine, School of MedicineAberrant expression of HOXA9 is a prominent feature of acute leukemia driven by diverse oncogenes. Here we show that HOXA9 overexpression in myeloid and B progenitor cells leads to significant enhancer reorganizations with prominent emergence of leukemia-specific de novo enhancers. Alterations in the enhancer landscape lead to activation of an ectopic embryonic gene program. We show that HOXA9 functions as a pioneer factor at de novo enhancers and recruits CEBPα and the MLL3/MLL4 complex. Genetic deletion of MLL3/MLL4 blocks histone H3K4 methylation at de novo enhancers and inhibits HOXA9/MEIS1-mediated leukemogenesis in vivo. These results suggest that therapeutic targeting of HOXA9-dependent enhancer reorganization can be an effective therapeutic strategy in acute leukemia with HOXA9 overexpression