Knockdown of VLCAD alters mitochondrial metabolism and reduces leukemia cell engraftment. Quantification of PDH activity (A), ATP levels (B), and (C) mitochondrial mass of TEX wild-type and VLCAD-knockdown cells. (D) Schematic diagram of the study, highlighting injection of an equal number of TEX wild-type or D6 cells into the tail vein of NSG mice. Engraftment levels were quantified at an intermediate time point of 5 weeks, via BM, and at the planned end point at day 101. Created using BioRender. (E) Engraftment levels of TEX wild-type and VLCAD-knockdown cells at the end point. (F) Overall survival of mice engrafted with TEX wild-type or D6 cells. *P = .0134, log-rank (Mantel-Cox) test. *P ≤ .05, **P ≤ .002, ***P ≤ .001, 1-way ANOVA with Tukey’s post hoc test (A-C); Mann-Whitney U test (E). With the exception of (D), all data are mean ± standard deviation.