PRKAA1 and acute lymphoblastic leukemia: Consequently, the AMPK knockdown data plus these findings in rapamycin-treated ALL cells support that the mechanism of metformin-induced cell death is dependent on AMPK activation, and that AMPK’s suppression of the UPR plus failure to down-regulate protein synthesis in metformin treated ALL cells undergoing proteotoxic/ER stress leads to apoptotic cell death.