CML stem cells alter extrinsic factors and upregulate expression of CD44+ and E-selectin to promote prominent BMM changes such as marrow fibrosis for exclusive stem cell engraftment and dormancy, offering protection from drug-targeting [25,152,154,158,159,160,161,162]. The gene discussed is CD44; the disease is chronic myelogenous leukemia, BCR-ABL1 positive.