The lineage-determining transcription factor C/EBPα is required for myeloid differentiation. Decreased function or expression of C/EBPα is often found in human acute myeloid leukemia. However, the precise impact of C/EBPα deficiency on the maturation arrest in leukemogenesis is not well understood. To address this question, we used a murine transplantation model of a bcr/abl induced myeloproliferative disease. The expression of bcr/abl in C/EBPα+/+ and C/EBPα+/− fetal liver cells lead to a chronic myeloid leukemia-like disease. Surprisingly, bcr/abl expressing C/EBPα−/− fetal liver cells fail to induce a myeloid disease in transplanted mice, but instead cause a fatal, transplantable erythroleukemia. Accordingly, increased expression of SCL and GATA-1 in hematopoietic precursor cells of C/EBPα−/− fetal livers was found. The mechanism for the lineage shift from myeloid to erythroid leukemia was studied in a bcr/abl positive cell line. Consistent with findings of the transplant model, expression of C/EBPα and GATA-1 was inversely correlated. Id1, an inhibitor of erythroid differentiation, was upregulated upon C/EBPα expression. Chromatin immunoprecipitation was done and C/EBPα binding to a 3 prime enhancer of the Id1 gene was observed. Downregulation of Id1 by RNA interference impaired C/EBPα induced granulocytic differentiation. Thus, Id1 is a direct and critical target of C/EBPα. Taken together, our study provides the first evidence that myeloid lineage identity of malignant hematopoietic progenitor cells requires the residual expression of C/EBPα.

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