Most patients with AML succumb to chemoresistant leukemia stem cells (LSCs), which persist and reinitiate disease years after clinical remission. In this issue of Cell Stem Cell, Jones et al., 2020Jones C.L. Stevens B.M. Pollyea D.A. Culp-Hill R. Reisz J.A. Nemkov T. Gehrke S. Gamboni F. Krug A. Winters A. et al.Nicotinamide Metabolism Mediates Resistance to Venetoclax in Relapsed Acute Myeloid Leukemia Stem Cells.Cell Stem Cell. 2020; 27 (this issue): 748-764Abstract Full Text Full Text PDF PubMed Scopus (20) Google Scholar identify a therapeutically targetable mechanism of resistance to venetoclax in relapsed and refractory AML LSCs mediated by nicotinamide metabolism.