C. Pospori, A. Donada, H. Boutzen, W. Grey, N. Rabas, N. Kassara, W. Sun, F. Birch, C. Georgiou, S. Gibson, A. A. Yong, A. Karoutas, T. Rizou, D. Vassiliadis, G. Stevens, T. J. Williams, R. Khorshed, M. Haltalli, A. Murison, M.-N. Skoufou, K. Sloan, H. Encabo, J. Hopkins, C. Christodoulidou, I. Rondriguez-Hernandez, P. Chakravarty, D. Stampoulis, S. Atkinson, F. Hearn-Yeates, K. Polizou, E. Trompouki, R. Burt, A. Innes, H. Stauss, R. Chakraverty, S. Z. Xie, M. Dawson, J. Dick, I. Malanchi, D. Bonnet, C. Lo Celso
How inflammation shapes acute myeloid leukaemia (AML) has come under scrutiny, as it may explain the disease resistance to immunotherapy approaches. IFNg has emerged as a key cytokine with paradoxical roles in suppressing and supporting AML growth, and the fundamental question of how leukemic stem cells (LSCs) respond to IFNg and whether IFNg signaling influences LSC quiescence and their capacity to regenerate disease over the long term remains unanswered. Here, we study primary human AML cells and murine models and combine bioinformatics analyses and functional assays to show that AML hierarchical heterogeneity is responsive to IFNg challenge. We uncover that IFNg triggers parallel stemness and differentiation programs; HSC/MPP-like cells enter deeper stemness, associated with quiescence and high leukaemia regeneration potential, while the surviving pool of progenitor-like cells divides faster but produces progeny that is quickly lost. Finally, with murine models we show that exposure to inflammation in vivo results in only transient impairment of leukaemia propagating capacity. This mechanism is driven by a previously unrecognised intraclonal fate bifurcation, relevant for the development of more effective therapeutic approaches.