PDK4 and B-cell acute lymphoblastic leukemia: In precursor B-cell acute lymphoblastic leukemia cells, the glucose analog 1,5-anhydroglucitol interrupts mitochondrial respiration by up-regulating pyruvate dehydrogenase kinase 4 (PDK4), thereby increasing the rate of glycolysis, and enhanced glycolysis leads to oxidative stress in tumor cells by increasing ROS levels [76,77].