Culturing primary B-ALL cells or Reh lymphoid cell line with bone marrow-derived MSCs under hypoxic conditions induces a higher expression of HIF-1α and therefore an acquisition of the glycolytic phenotype of leukemic cells, which in part is due to signaling-regulated by the AKT/mTOR pathway induced by stromal cells. Here, HIF1A is linked to acute lymphoblastic leukemia.