BIRC5 and acute myeloid leukemia: Moreover, the expression of survivin was transcriptionally up-regulated by Sp1 and c-Myc via the ERK-MSK pathway, and constitutively active (phosphorylated) ERK/MSK in CD34+ AML patients was required for the phosphorylation (i.e., activation) of Sp1, thereby leading to over-expression of survivin.