In chronic myeloid leukemia, patients whose leukemic cells harbor increased Twist1 are more likely to fail therapies with tyrosine kinase inhibitors.33 Similarly in myelodysplastic syndrome, the expression levels of Bmi1 are higher in those with advanced-stage diseases, and it predicts a potential of earlier progression in low-risk patients.21 Our Twist1-overexpressing AML patients exhibited a more aggressive clinical phenotype as well, as a more significant proportion of these patients were thrombocytopenic and/or had a PB blast count >30%. Here, BMI1 is linked to acute myeloid leukemia.