Oncofusion

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Mechanismstrong confidence 4 of 5: Replicated in peer-reviewed work by more than one group.Q59-marks2

H3K9me3 - measured in KMT2A::AFF1 cells, in a supplementary figure, and it rises GENERALLY where H3K27ac falls SPECIFICALLY in the same experiment

also called H3K9me3 · H3K9 trimethylation · histone H3 lysine 9 trimethylation · H3K9Me3 · trimethyl-H3K9

H3K9me3 is the tag that locks a stretch of DNA into silent, tightly packed chromatin. In KMT2A-fusion leukaemia it is the brake: the enzymes that write it push down the very genes the fusion needs, and leukaemia stem cells carry less of it than normal blood stem cells. When a DOT1L inhibitor is given it goes up - but everywhere, not just at the genes the drug is aimed at.

The same thing, for a scientist

H3K9me3 is the constitutive-heterochromatin mark written by SUV39H1/H2 and SETDB1, read by HP1 proteins, and erased by the KDM4/JMJD2 demethylases. **In KMT2A-rearranged leukaemia it behaves as a tumour suppressor at the fusion's own target genes.** SETDB1 binds the PAF1 complex - the complex this graph already holds as required for fusion localisation - and the PAF1c-SETDB1 interaction deposits promoter H3K9me3 at *Meis1* and *Hoxa9*, repressing them in MLL-AF9-transformed AML cells; stabilising that interaction with a CDC73_3YF mutant, or over-expressing SETDB1, raises the mark and lowers the transcripts, and in human AML higher SETDB1 tracks with lower HOXA9 and MEIS1 [E1, E2]. Independently, SUV39H1 is down-regulated across leukaemias including MLL-r AML, and both Suv39h1 expression and **genomic H3K9me3 occupancy are decreased in leukaemia stem cells from MLL-r models relative to their normal counterparts** [E3]. **The measurement in the index fusion exists and is easy to miss.** In human SEM cells (KMT2A::AFF1) a DOT1L inhibitor produces a modest increase in H3K9me3 that the authors describe as *general* - it occurs at H3K79me2/3-marked enhancers, at non-KEE enhancers and at a non-enhancer control region alike - and they conclude explicitly that it does **not** explain the KEE-specific changes [E4]. That result is in Supplementary Fig. 4b-e of a paper whose abstract names neither H3K9me3 nor SEM, and it is the cleanest available contrast to H3K27ac, which falls at KEEs only in the very same experiment.

Go deeper
The same drug, the same cells, two marks, two geometries

PMID 31243293 ran H3K27ac and H3K9me3 in SEM (KMT2A::AFF1) cells under DOT1L inhibition, and the two marks answer this graph's standing question in opposite directions:

markdirection under DOT1Liscopeauthors' own conclusion
H3K27acdownKEEs only; no global changemediates the loss of accessibility and TF binding at KEEs
H3K9me3up (modest trend)general - KEEs, non-KEEs and a non-enhancer control"do not explain the specific changes in TF binding at KEEs"

This is worth stating plainly because the graph has repeatedly found claims that blur fusion-target and genome-wide effects. Here one experiment contains both shapes, and the authors say which is which. It also constitutes a published, in-house counter-argument to the model that DOT1L inhibition works by permitting targeted heterochromatinisation of fusion targets [E4 against E5].

Why this mark is a brake on the fusion, not a consequence of it

The PAF1c route. SETDB1 was found as a novel PAF1-complex interactor by proteomics; stabilising that interaction with a CDC73 3YF mutant that cannot support AML growth, or over-expressing SETDB1, increases promoter H3K9me3 at Meis1 and Hoxa9 and reduces their transcription in AML cells 1. The follow-up shows genes directly bound by MLL-AF9 are significantly down-regulated on SETDB1 over-expression, that 193 of those genes have reduced promoter H3K9 methylation in AML patient samples relative to normal CD34+ cells, and that SETDB1 knockout in human THP-1 cells up-regulates an overlapping set 2. This graph already holds gene-paf1, gene-cdc73, gene-ctr9 and gene-leo1 as the machinery that puts the fusion on chromatin; the same complex carries the enzyme that shuts the fusion's targets down.

The SUV39H1 route. SUV39H1, the dominant H3K9 methyltransferase in haematopoiesis, is down-regulated in several leukaemias including MLL-r AML, and both its expression and genomic H3K9me3 occupancy are reduced in MLL-r leukaemia stem cells compared with their normal counterparts 3. The same work notes that SUV39H1 has been reported to interact with menin, which makes it the one H3K9 writer with a stated physical connection to this project's central druggable interface - a connection nobody has followed up under a menin inhibitor.

The direction matters therapeutically. If H3K9me3 restrains the fusion programme, then agents that lower it - and G9a/EHMT2 inhibitors such as UNC0638 lower H3K9me2 and H3K9me3 together 2 - are pointed the wrong way in this disease, whatever their effect on normal progenitors.

The eraser and reader arms, and what the graph already has

Erasers. The KDM4/JMJD2 family demethylates H3K9me2/3; gene-kdm4c is in this graph and KDM4 inhibition has been reported to attenuate leukaemia stem cells. No KDM4 experiment in a KMT2A-rearranged cell has reported H3K9me3 at fusion-bound loci.

Readers. HP1 proteins (CBX1/CBX3/CBX5) read H3K9me3. This graph has no entry for any of them, which is a real gap now visible from the mark side: the H3K9me3 story here runs writer-to-phenotype with the reader step entirely unwritten.

The H3.3 connection. ATRX and DAXX deposit histone variant H3.3 and maintain H3K9me3 at heterochromatin (gene-atrx, gene-daxx), and gene-hira records a 2026 CML result in which HIRA knockdown raises H3K9me3 through SETDB1. So the chaperone layer this graph already carries touches this mark in two directions, in two diseases, and in neither case in a KMT2A-rearranged cell.

A crosstalk route worth naming. KDM2B has been proposed to act as an H3K79me2/3 demethylase causing SIRT1 recruitment and gain of H3K9me3 [E4, citing prior work]; gene-kdm2b is in this graph as a PRC1.1 subunit. That places one protein at the junction of the H3K79, H3K9 and H2AK119ub arms, and it has never been tested in a KMT2A-rearranged cell.

The bounded absences

(KMT2A term set)[tiab] AND (H3K9me3 OR "H3K9 trimethylation")[tiab] returns 10 records on 2026-09-20 against 2,793 for H3K9me3[tiab] alone and 3,209 for the KMT2A set alone. PMID 31243293 is not among the ten 4, which is the second time in this beat that the strongest KMT2A::AFF1 measurement of a mark sat outside its own bounded query.

No H3K9me3 measurement exists under a menin inhibitor: the name-list-bounded drug query returns one irrelevant record, and three menin-inhibitor chromatin full texts contain the string zero times (counts and name list in mark-h3k27ac E6). Given that SUV39H1 is reported to interact with menin 3, that absence is more surprising than most.

No H3K9me3 measurement exists in infant material, in a B-lineage primary sample, or at fusion-bound loci in KMT2A::AFF1 - the SEM data 4 are enhancer-and-control regions, not a fusion-occupancy-anchored map.

Facts and figures
markH3K9me3
histoneH3
residueK9, N-terminal tail
chemistrytrimethylation; mutually exclusive with H3K9ac on the same residue
variant linkATRX-DAXX deposit H3.3 and maintain H3K9me3 at heterochromatin (gene-atrx, gene-daxx)
measured in kmt2a rtrue
measured in kmt2a aff1true
measured in infant materialfalse
measurement scopeGENERAL in the index fusion - increases at KEEs, non-KEEs and a non-enhancer control alike under DOT1L inhibition (PMID 31243293, SEM); LOCUS-RESOLVED in myeloid models at Meis1 and Hoxa9 promoters (PMIDs 29774127, 33054052)
direction in diseasetumour-suppressive at fusion targets: raising it lowers Hoxa9/Meis1; LSCs from MLL-r models carry less of it than normal counterparts
dot1l inhibitor effectmodest general increase in SEM (H3K9me3, PMID 31243293); targeted increase in murine MLL-AF9 at fusion-bound TSSs but measured as H3K9me2 (PMID 25822366)
menin inhibitor effectnever measured, despite a reported SUV39H1-menin interaction
spike in normalisedfalse
named in entries when written19
mentions when written61
count methodregex /\bH3K9me3/i over all 1,701 node JSON files, run 2026-09-20
abstract query count 2026 09 2010
rule 80 changed the answertrue
writers named in sources
[
  "SETDB1 (Q15047, 1,291 aa; no gene entry in this graph as of 2026-09-20)",
  "SUV39H1 (O43463, 412 aa; no gene entry in this graph as of 2026-09-20)",
  "EHMT2/G9a (no gene entry; UNC0638 is the tool used)"
]
erasers
[
  "gene-kdm4c"
]
readers unwritten in this graph
[
  "CBX5/HP1alpha",
  "CBX1/HP1beta",
  "CBX3/HP1gamma"
]
abstract query misses
[
  "31243293"
]
How this could bite us back
  • H3K9 methyltransferase inhibitors are in clinical development, and in this disease the published direction is that H3K9 methylation restrains the fusion's targets - so a G9a or SETDB1 inhibitor given to a KMT2A-rearranged patient is a candidate for making the leukaemia worse, not better.
  • Conversely, an agent raising H3K9me3 globally would silence indiscriminately; the SEM experiment shows the mark rises at enhancers, non-enhancers and controls alike under a DOT1L inhibitor, so 'raise H3K9me3' is not an addressable intervention at fusion loci.
  • SUV39H1 declines with normal ageing in HSCs, so any therapeutic manipulation of this axis in an infant is acting on a system whose baseline is the opposite of the one most of the published data were collected in.
  • If DOT1L inhibition works partly by allowing heterochromatinisation, then combining it with an H3K9 methyltransferase inhibitor - a combination that looks attractive because both are 'epigenetic drugs' - is antagonistic by construction.
Still open
  1. Is the H3K9me3 increase under DOT1L inhibition genuinely global? The SEM experiment tests selected loci plus controls without spike-in normalisation, which is precisely the design that cannot distinguish a global rise from no rise at all.
  2. Does a menin inhibitor change H3K9me3 at fusion targets? SUV39H1 is reported to interact with menin, the reagents are standard, and no published study has looked in any system.
  3. Which H3K9 methylation state actually matters at fusion targets - me2 or me3? The targeted result in murine MLL-AF9 is me2 and the untargeted result in human KMT2A::AFF1 is me3, and the two literatures do not address each other.
  4. Does an HP1 protein read this mark at fusion-bound loci? This graph has no entry for CBX1, CBX3 or CBX5, and the whole H3K9me3 story in this disease is currently writer-to-phenotype with the reader missing.
Every source behind this entry (6)
  1. E1strong confidence 4 of 5: Replicated in peer-reviewed work by more than one group.paper

    In MLL-AF9-transformed AML cells, the PAF1 complex physically interacts with the H3K9 methyltransferase SETDB1 - an interaction stabilised by a CDC73_3YF mutant that cannot support AML cell growth - and over-expression of SETDB1 or stabilisation of the PAF1c-SETDB1 interaction increases promoter H3K9 trimethylation at Meis1 and Hoxa9 by ChIP while reducing their transcription; in human AML patients higher SETDB1 expression is associated with reduced HOXA9 and MEIS1.

    What this evidence cannot show

    Read in full text (PMC5955148). Murine MLL-AF9-transformed myeloid cells; the human component is an expression correlation across patient cohorts, not a chromatin measurement in patients. The causal arm runs through over-expression and a gain-of-interaction mutant rather than through loss of SETDB1, so the physiological contribution of endogenous SETDB1 at these promoters is inferred. Published in Oncotarget, a journal whose editorial standards over this period have been questioned - the finding is reproduced by the same group in Haematologica [E2], which is why the pair is cited together.

    Evidence that argues against this (1)
    • SETDB1 is also reported to have oncogenic roles in other tumour types and the H3K9 methyltransferases display both tumour-suppressive and tumour-promoting behaviour in the same tissue, so a repressive effect at two loci does not establish a net direction for the enzyme in this disease. The companion paper makes this point about its own result. Ropa J; Saha N; Hu H; Peterson LF; Talpaz M; Muntean AG 2020
  2. E2strong confidence 4 of 5: Replicated in peer-reviewed work by more than one group.paper

    SETDB1-mediated histone H3 lysine 9 methylation suppresses MLL-fusion target expression and leukaemic transformation: genes directly bound by MLL-AF9 are significantly down-regulated on SETDB1 over-expression in mouse MLL-AF9 cells, 193 of those genes have reduced promoter H3K9 methylation in AML patient samples relative to normal human CD34+ cells, an overlapping set is up-regulated by CRISPR-Cas9 SETDB1 knockdown in human THP-1 cells, and the G9a inhibitor UNC0638 reduces both H3K9me2 and H3K9me3 in mouse lineage-negative bone marrow.

    SETDB1 mediated histone H3 lysine 9 methylation suppresses MLL-fusion target expression and leukemic transformation. · Ropa J; Saha N; Hu H; Peterson LF; Talpaz M; Muntean AG · Haematologica 2020
    What this evidence cannot show

    Read in full text (PMC7556517). Mouse MLL-AF9 plus human THP-1 (KMT2A::MLLT3, myeloid) - no B-lineage and no KMT2A::AFF1. The patient-sample H3K9 methylation comparison is taken from a prior dataset rather than generated here, and it is H3K9 methylation broadly rather than H3K9me3 specifically. **UNC0638 is a G9a/EHMT2 inhibitor used as a proxy because no selective SETDB1 inhibitor exists**, so the pharmacological arm addresses H3K9 methyltransferases as a class and not SETDB1.

    Evidence that argues against this (1)
    • If H3K9 methylation were broadly repressive to the MLL-AF9 programme, DOT1L inhibition - which raises H3K9me3 - should be more effective than it is, and the SEM experiment shows the increase is general rather than targeted, so a global rise in the mark does not by itself silence fusion targets. Godfrey L; Crump NT; Thorne R; Lau IJ; Repapi E; Dimou D; et al. 2019
  3. E3strong confidence 4 of 5: Replicated in peer-reviewed work by more than one group.paper

    SUV39H1, the dominant H3K9 methyltransferase in the haematopoietic system, is down-regulated in a variety of leukaemias including MLL-rearranged AML, and both decreased Suv39h1 expression and decreased genomic H3K9me3 occupancy are observed in leukaemia stem cells from MLL-rearranged models compared with their normal counterparts; SUV39H1 has also been reported to interact with menin.

    SUV39H1 regulates the progression of MLL-AF9-induced acute myeloid leukemia. · Chu Y; Chen Y; Guo H; Li M; Wang B; Shi D; et al. · Oncogene 2020
    What this evidence cannot show

    Read in full text (PMC7728597). Mouse MLL-AF9 LSC and L-GMP populations plus in-house patient bone marrow CD34+ comparisons; myeloid throughout. The menin interaction is cited by these authors to prior work rather than demonstrated here, so it is recorded in this entry as a lead and not as a measurement. 'Genomic H3K9me3 occupancy' is a distributional statement across the stem-cell compartment, not a fusion-target-anchored map.

    Evidence that argues against this (1)
    • SUV39H1 expression declines with normal ageing in human and mouse HSCs, producing global H3K9me3 reduction independently of any leukaemia, so lower SUV39H1 and lower H3K9me3 in a leukaemia stem cell may reflect the proliferative or stem state rather than the fusion. Chu Y; Chen Y; Guo H; Li M; Wang B; Shi D; et al. 2020
  4. E4strong confidence 4 of 5: Replicated in peer-reviewed work by more than one group.paper

    In human SEM cells (KMT2A::AFF1 / MLL-AF4 B-ALL), DOT1L inhibition produces only a modest trend towards increased H3K9me3, and that increase is general - occurring at H3K79me2/3-marked enhancers (KEEs), at non-KEE enhancers and at a non-enhancer control region alike - so the authors conclude it does not explain the KEE-specific losses of H3K27ac, chromatin accessibility and transcription-factor binding seen in the same experiment.

    DOT1L inhibition reveals a distinct subset of enhancers dependent on H3K79 methylation. · Godfrey L; Crump NT; Thorne R; Lau IJ; Repapi E; Dimou D; et al. · Nat Commun 2019
    What this evidence cannot show

    Read in full text (PMC6594956); the data are **Supplementary Fig. 4b-e** and the abstract names neither H3K9me3 nor the cell line, so this paper is absent from the bounded H3K9me3 x KMT2A abstract query. The measurement is ChIP at selected example loci plus control regions rather than a genome-wide H3K9me3 map, so 'general' is supported across the regions tested and is not a whole-genome statement. One cell line, one inhibitor, no spike-in normalisation - and for a mark expected to move globally, the absence of spike-in normalisation is a sharper limitation here than for H3K27ac.

    Evidence that argues against this (1)
    • The targeted model is on record from an independent group: in murine MLL-AF9 cells DOT1L inhibition recruits SIRT1 and SUV39H1 to MLL-AF9-bound TSSs and increases H3K9me2 there specifically. The two studies differ in methylation state (me2 versus me3), in lineage, in species and in whether the effect is targeted, and nobody has reconciled them. Chen CW; Koche RP; Sinha AU; Deshpande AJ; Zhu N; Eng R; et al. 2015
  5. E5strong confidence 4 of 5: Replicated in peer-reviewed work by more than one group.paper

    In mouse MLL-AF9 leukaemia cells, DOT1L inhibition increases H3K9 dimethylation and H3K27 trimethylation around the transcription start sites of MLL-AF9-bound genes, and Suv39h1 is required for the Sirt1-dependent H3K9 methylation and silencing of the MLL-AF9 leukaemic programme.

    DOT1L inhibits SIRT1-mediated epigenetic silencing to maintain leukemic gene expression in MLL-rearranged leukemia. · Chen CW; Koche RP; Sinha AU; Deshpande AJ; Zhu N; Eng R; et al. · Nat Med 2015
    What this evidence cannot show

    Read in full text (PMC4390532). The mark measured is H3K9me2 (antibody Abcam ab1220), **not H3K9me3**, so this evidence item is adjacent to rather than about the subject of this entry; it is included because it is the only targeted H3K9-methylation result in this disease and because it is the direct counterpart to [E4]. Murine myeloid; the human lines in that study were assayed for H3K9ac, not for H3K9 methylation.

    Evidence that argues against this (1)
    • The SEM experiment finds the H3K9me3 increase under DOT1L inhibition to be untargeted and explicitly insufficient to explain the locus-specific effects, and the two results are in different methylation states, different lineages and different species. Whether SIRT1-SUV39H1 silencing is a general consequence of DOT1L inhibition or a feature of the murine myeloid system is open. Godfrey L; Crump NT; Thorne R; Lau IJ; Repapi E; Dimou D; et al. 2019
  6. E6established confidence 5 of 5: Multiple independent lines of evidence; treated as settled in the field.database

    As of 2026-09-20 PubMed returns 10 records for the KMT2A term set intersected with (H3K9me3 OR 'H3K9 trimethylation')[tiab], against 2,793 for H3K9me3[tiab] alone and 3,209 for the KMT2A term set alone; PMID 31243293, which contains the only KMT2A::AFF1 H3K9me3 measurement found in this beat, is not among the ten.

    What this evidence cannot show

    **Ten in titles and abstracts; supporting figures not searched by the query.** The bound was extended by reading fourteen core KMT2A-r chromatin full texts, which is how PMID 31243293's supplementary H3K9me3 panel was recovered. Fourteen full texts is not the whole literature. The name list was H3K9me3 and 'H3K9 trimethylation'; 'H3K9 methylation' bare was not run against the KMT2A set and would widen the count, and would also pull in me1 and me2. Querytranslations were read back and none contained a [UID] term.

    Evidence that argues against this (1)
    • Several of the ten records are on-topic and were rejected for this entry rather than being absent: a TWIST1 leukaemia-stem-cell paper, a KDM4 inhibitor study, a PBX3 stem-cell paper and a CXXC-domain study each mention the mark incidentally without measuring it at fusion-bound loci. A count of ten is not ten measurements. Ropa J; Saha N; Hu H; Peterson LF; Talpaz M; Muntean AG 2020
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