H19 and acute myeloid leukemia: This study further demonstrated how H19 acts in trans to modulate promoter methylation of key hematopoietic transcription factors like Runx1 and Spi1. In human AML cell lines, H19 knockdown caused a decrease in proliferation and increase in apoptosis (70, 72), while elevated expression correlated with poor treatment response and overall survival in patients (72).