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doi: 10.1038/ng.3760 5
It is a substrate: cells need it to run the electron transport chain, generate ATP, and activate a class of repair enzymes called sirtuins and PARPs
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Apart from nicotinamide metabolism adaption during disease relapse or refractory stages, earlier studies have shown the leukemic blasts and LSCs have evolved a complex adaptation of metabolic flexibility through cell intrinsic, partly due to the selection pressure from the chemotherapy and through various microenvironmental mechanisms
