ITGA4 and acute lymphoblastic leukemia: Also, they tested mono DEX in RS4;11 (pro-B-ALL) and detected repression of ITGA4, IL7R, and BCL6. In both pro- and pre-B-ALL cells, DEX exposure leads to the downregulation of BCL6. However, in our pro-B-ALL RS4;11 cells, the combined drug incubation DEX + IDEL suppresses this effect without neutralizing it entirely, while in SEM, the drug combination enhanced the downregulation of BCL6. BCL6 is expressed in pre-B cells, acts as a transcription factor, and is necessary for maturation of pro- to pre-B cells [15].