X P. Supplementary Figure 1. Nature Medicine: doi: /nm Nilotinib LSK LT-HSC. Cytoplasm. Cytoplasm. Nucleus. Nucleus

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1 a b c Supplementary Figure 1 c-kit-apc-eflu780 Lin-FITC Flt3-Linc-Kit-APC-eflu780 LSK Sca-1-PE-Cy7 d e f CD48-APC LT-HSC CD150-PerCP-cy5.5 g h i j Cytoplasm RCC1 X Exp 5 mir 126 SPRED1 SPRED1 RAN P SPRED1 Pre mir 126 Pre mir 126 Pri mir 126 Pri mir 126 BCR ABL P P SPRED1 Nucleus Cytoplasm mir 126 mir 126 mir 126 RAN RAN Exp 5 RCC1 Pre mir 126 Pri mir 126 Nilotinib BCR ABL X P SPRED1 Nucleus k Differentially Expressed mirnas Fold change >= 2 or <= 0.5 FDR <= 0.05 BCR/ABL No BCR/ABL

2 Supplementary Figure 1, BCR-ABL down-regulates mir-126 expression in CML cells (a) Representative flow cytometry plots of the populations sorted from the BM of normal and CML mice including Lin - Sca-1 - c-kit - (L - S - K - ), Lin - Sca-1 - c-kit + (L - S - K + ), Lin - Sca-1 + c-kit + (LSK) and LSK Flt3 - CD150 + CD48 - (LT-HSCs). (b) PIK3R2 and (c) SPRED1 expression in human normal and CML CD34 + subpopulations as assessed by QPCR (n=8 independent samples). (d) PIK3R2 (n=3) and (e) SPRED1 (n=4) levels in mouse normal LSK cells transduced with BCR-ABL retroviral or control construct as assessed by QPCR (n=3 independent experiments). (f) PIK3R2 and (g) SPRED1 expression in human CML Lin - CD34 + CD38 - cells treated with NIL (n=3 biologically independent samples) and (h) mir-126 expression in human normal Lin - CD34 + CD38 - cells treated with NIL (n=3 biologically independent samples). (i) mir-126 staining in K562 cells treated with and without 5 µm NIL. The experiments were repeated 3 times with similar results. (j) Schematic model of BCR-ABL regulated mir-126 biogenesis through SPRED1 and RAN/Exp-5/RCC1 complex in the absence (left panel) or presence of NIL (right panel). (k) Heatmap of differentially expressed mirnas measured by mirna-sequencing. Comparison between groups was performed by two-tailed, unpaired Student's t-test. P values <0.05 were considered significant. Results shown represent mean ± SEM. p < 0.05, p < 0.01, p <

3 Supplementary Figure 2 a b c d CML Lin - CD34 + CD38 - e f +none + ctrl HUVEC + KD HUVEC mir-126 DAPI Merge g Cell cycling Ki-67-FITC CML Lin - CD34 + CD38 - cells + none + ctrl HUVEC + KD HUVEC h DAPI Apoptosis DAPI Annexin V-PE i j k l

4 Supplementary Figure 2, Endothelial cells in the niche supply mir-126 to CML LT-HSCs (a) mir-126 levels in HUVECs (n=6 independent experiments) and human CML CD34 + subpopulations (n=12 biologically independent samples in each group) as assessed by QPCR. (b,c) mir-126 expression as assessed by QPCR (n=4) (b) and by mirna staining in HUVECs transduced with mir-126 KD or control lentiviruses (n=3 independent experiments) (c). (d,e) mir-126 expression as assessed by mirna staining (n=3 independent experiments with similar results) (d) and QPCR (n=4 independent samples) (e) in CML Lin - CD34 + CD38 - cells co-cultured with ctrl or KD HUVECs or none. (f-h) Accumulated results (f) and representative plots of cell cycling (n=3 independent samples), and representative plots (g) and accumulated results of apoptosis (n=4 independent samples) (h) in CML Lin - CD34 + CD38 - cells co-cultured with ctrl or KD HUVECs or none for 72h. (i) The percentage of CD34 + cells from f-h was assessed by flow cytometry at 96h (n=4). (j-l) Human CD45 + cells in PB at 6 weeks (n=8) (j) and in BM at 16 weeks (n=8) (k), and Bcr-Abl expression in BM at 16 weeks (n=8) (l) assessed by QPCR (n=8), from NSG-SGM3 mice transplanted with CML CD34 + cells after co-culture with ctrl or KD HUVECs or none for 96h. Comparison between groups was performed by two-tailed, unpaired Student's t-test. P values <0.05 were considered significant. Results shown represent mean ± SEM. p < 0.05, p < 0.01, p <

5 a b c Ctrl HU EVs 100 nm KD HU EVs 100 nm Supplementary Figure 3 Supernatant EVs Ctrl HU KD HU IB: CD63, 43 KDa IB: TSG101, 49 KDa IB: HSP90, 90 KDa IB: Cytochrome C, 12 KDa d e f IgG Ctrl HU KD HU CD63 IgG Ctrl HU KD HU CD9 IgG Ctrl HU KD HU CD81 CD63-PE-Cy7 CD9-FITC CD81-APC g h i j HUVEC Actin/miR-126 mir-126 K562 mir-126/dapi CML Lin - CD34 + CD38 - +ctrl HU EVs + KD HU EVs Ki-67-PE 22% 28% 25% 32% 5µm 49% 38% DAPI k l CML Lin - CD34 + CD38 - m n +ctrl HU EVs + KD HU EVs DAPI Annexin V-PE o p q r s t

6 Supplementary Figure 3, Endothelial cells in the niche supply mir-126 to CML LT-HSCs (a) EVs isolated from control and mir-126 KD HUVECs were visualized by electron microscopy. The experiments were repeated twice with similar results. (b) The size and concentration of EVs isolated from the supernatants of both control (ctrl) and mir-126 KD HUVECs was analyzed by NanoSight using nanoparticle tracking assays (n=3 independent experiments). (c) Expression of exosome-specific proteins (CD63, TSG101), EV-associated protein HSP90 and mitochondrial protein Cytochrome C in EVs isolated from ctrl or mir-126 KD HUVECs or in HUVEC supernatant (negative control), as assessed by western blot. The experiments were repeated twice with similar results. Full-length gels and blots with molecular weight standards were provided in Supplementary Fig. 10. (d) Expression of exosome-specific proteins on CD63 + HUVEC-derived EV fraction, purified with magnetic beads coated with anti- CD63 antibody, as assessed by cytofluorimetric analyses using antibodies to tetraspanins (CD63, CD9 and CD81) (n=3 independent experiments with similar results). (e) mir-126 levels, as assessed by QPCR, in total EVs, CD63 + and CD63 - HUVEC-derived EV fractions (n=3 independent experiments). (f) mir-126 expression, as assessed by QPCR, in EVs harvested from human normal and CML Lin - CD34 + CD38 - HSCs as well as ctrl and mir-126 KD HUVECs (n=3 independent experiments). (g,h) mir-126 fluorescence signal in HUVECs (g) and in K562 cells co-cultured with the pre-stained HUVEC-derived EVs (h). These experiments were repeated twice with similar results. (i-m) mir-126 levels as assessed by QPCR (n=3 independent samples) (i), representative plots (j) and accumulated results (k) of cell cycling (n=3), and representative plots (l) and accumulated results (m) of apoptosis (n=3) in human CML HSCs co-cultured with ctrl or KD HUVEC-derived EVs for 96h. (n) mir-126 levels, as assessed by QPCR (n=3 independent experiments), in mir-126 KO CML LT-HSCs from BCR- ABL-induced and pipc-injected SCLtTA/BCR-ABL/miR-126 flox/flox /Mx1-cre + mice co-cultured with ctrl or mir-126 KD HUVEC-derived EVs or cultured alone for 48 h. (o, p) Human CD45 + (o) and

7 CD45 + CD34 + (p) cell engraftment in BM at 16 weeks from NSG-SGM3 mice transplanted with CML Lin - CD34 + cells co-cultured with ctrl (n=9) or KD (n=8) HUVEC-derived EVs for 96h. (q-t) mir-126 expression in donor CML LT-HSCs (n=3) (q), WBC counts (r) and donor CML cell engraftment in PB (s) and survival (t) of the CD45.1 recipient mice transplanted with CD45.2 CML LT-HSCs co-cultured with ctrl (n=10) or KD (n=9) HUVEC-derived EVs for 96h. Comparison between groups was performed by two-tailed, unpaired Student's t-test. P values <0.05 were considered significant. Results shown represent mean ± SEM. p < 0.05, p < 0.01, p <

8 a b c d Percentage Cell cycling-nil * Ctrl * ns * mir-126 KD mir-126 OE * ns Supplementary Figure 4 0 G0 G1 S/G2/M e f g h Colonies (relative to ctrl) Ctrl mir-126 KD mir-126 OE Percentage Cell cycling-nil * * ns * Ctrl mir-126 KD mir-126 OE * ns G0 G1 S/G2/M i % of Annexin V + cells Ctrl mir-126 KD mir-126 OE j Luminescent Cell Viability Assay Cell growth-nil Ctrl * * ** mir-126 KD mir-126 OE k Colonies (relative to ctrl) CFC-NIL ** * *** Ctrl mir-126 KD mir-126 OE

9 Supplementary Figure 4, mir-126 knockdown enhanced TKI-mediated targeting of CML LSCs (a-f) mir-126 expression (a), cell cycling (b), apoptosis (c), cell growth (d), CFC (e), and CFC replating efficiency (f) in human CML Lin - CD34 + CD38 - cells transduced with mir-126 KD or mir-126 OE or control lentiviruses, with or without NIL (5 µm) for 72h (n=4 independent experiments for all assays). (g-k) mir-126 expression (g), cell cycling (h), apoptosis (i), cell growth (j) and CFC (k) (n=4 independent experiments for all) in mouse CML LT-HSCs transduced with mir-126 KD or mir-126 OE or control lentiviruses, with or without NIL (5 µm) for 72h. Comparison between groups was performed by two-tailed, paired Student's t-test. P values <0.05 were considered significant. Results shown represent mean ± SEM. p < 0.05, p < 0.01, p <

10 a b c e d Ctrl mir-126 KD Supplementary Figure 5 CD33-PE NIL mir-126 KD+NIL CD45-APC f g h SPRED1 p-erk BCL-2 β-actin Ctrl NIL mir-126 KD mir-126 KD+NIL 50 kda 42/44 kda 28 kda 43 kda i j k Ctrl mir-126 KD l m siscr sispred1 n DAPI siscr SPRED1 p-erk BCL-2 β-actin 50 kda 42/44 kda 28 kda 43 kda SPRED1 p-erk BCL-2 β-actin 50 kda 42/44 kda 28 kda 43 kda sispred1 Annexin V-PE o p CML2 CML1 p-erk β-actin p-erk β-actin Ctrl NIL MEK inhibitor 42/44 kda 43 kda 42/44 kda 43 kda q r s Apoptosis *** ** ** * **

11 Supplementary Figure 5, mir-126 knockdown enhances TKI-mediated targeting of CML LSCs (a,b) Representative plots of human CD45 + cell engraftment (a) and BCR-ABL expression by QPCR (n=7 independent samples) (b) in BM cells from NSG-SGM3 mice transplanted with human CML HSCs with or without mir-126 KD by lentiviruses transduction and treated with or without NIL (5 µm) for 4 days. (c-e) apoptosis (n=4 independent experiments) (c), cell growth (n=4) (d) and CFC (n=4) (e) in human CML HSCs co-cultured with ctrl or KD HUVECs or none, with or without NIL (5 µm), for 96h. (f-g) apoptosis (n=4 independent experiments) (f) and cell growth (n=4) (g) in human CML HSCs co-cultured with ctrl or KD HUVEC-derived EVs or cultured alone, with or without NIL (5 µm), for 96h. (h) SPRED1, p-erk, BCL-2 and β-actin (loading control) proteins in human CML Lin - CD34 + cells with or without mir-126 KD and treated with or without NIL (2 µm), as assessed by western blot. The experiments were repeated twice using independent samples with similar results. (i-j) SPRED1 mrna in NILtreated cells at indicated times (n=4 independent experiments) (i) and in mir-126 KD cells (n=4 independent experiments) (j) from h, as assessed by QPCR. (k) SPRED1, p-erk, BCL-2 and β- actin in mir-126 KD cells from h, as assessed by western blot. The experiments were repeated twice using independent samples with similar results. (l,m) SPRED1 mrna by QPCR (n=4 independent experiments) (l) and SPRED1, p-erk, BCL-2 and β-actin expression by western blot (m) in CML Lin - CD34 + cells with SPRED1 KD by sirna transduction. The experiments were repeated twice using independent samples with similar results. (n,o) representative plots (n) and accumulated results (n=4 independent samples) (o) of apoptosis in SPRED1 KD CML Lin - CD34 + cells treated with and without NIL (2 µm) for 48h. (p,q) p-erk and β-actin expression by western blot (p) and apoptosis (n=4) (q) in CML Lin - CD34 + cells treated with NIL (2 µm), or MEK inhibitor PD (500nM) or combination for 72h. The experiments were repeated twice using independent samples with similar results. (r,s) BCL-2 by QPCR (r) and apoptosis by flow cytometry(s) in CML Lin - CD34 + cells with BCL-2 KD by sirna transduction and treated with

12 and without NIL (2 µm) for 48h (n=4 independent experiments for both). Full-length gels and blots with molecular weight standards for 5h, k, m, p were provided in Supplementary Fig. 10. Comparison between groups was performed by two-tailed, unpaired Student's t-test. P values <0.05 were considered significant. Results shown represent mean ± SEM. p < 0.05, p < 0.01, p <

13 a 4h Control Ab-NP TF-NP CpG b 24h Control Ab-NP TF-NP CpG c Supplementary Figure 6 Cy3 Cy3 d Control HUVEC e HUVEC Normal CML Control Normal1 Normal2 f Control CML1 CML2 g Cy3 Cy3 Cy3 h i j Normal k scrrna Inhibitor 25% 36% CML scrrna Inhibitor 34% 44% 70% 60% 61% 50% l m n Normal EdU-APC scrrna Inhibitor 18% 27% CML 34% 40% o p q DAPI

14 Supplementary Figure 6, Effective in vitro and in vivo uptake and gene silencing effects of the CpG-miR-126 inhibitor (a-c) Uptake of Cy3 as assessed by flow cytometry at 4h (a) and 24h (b) and mir-126 expression as assessed by QPCR at 24h (c) in K562 cells after addition of CpG-miR-126 inhibitor-cy3 (200 nm), Ab-NPs or TF-NPs containing mir-126 inhibitor-cy3 (200 nm), or naked mir-126 inhibitor-cy3 (200 nm, control) (n=3 independent experiments with similar results). (d-i) Uptake of Cy3 in HUVECs(d), human normal (e) and CML (f) Lin - CD34 + CD38 - cells at 4h and mir-126 expression in HUVECs (g), normal (h) and CML (i) Lin - CD34 + CD38 - cells at 24h post treatment with CpG-miR-126 inhibitor-cy3 (500nM) (n=4 independent samples for all). (j,k) Cell cycling in normal (j) and CML (k) Lin - CD34 + CD38 - cells treated with CpG-miR-126 inhibitor (500 nm), as assessed by EdU and DAPI staining. The experiments were repeated twice using biologically independent samples with similar results. (l,m) uptake of Cy3 by flow cytometry at 4h (l) and mir-126 expression by QPCR at 24h (m) in CML BM mononuclear cells, LT-HSCs and ECs treated with CpG-miR-126 inhibitor-cy3 (500nM) (n=4 biologically independent samples for all). (n) Cell cycling by EdU and DAPI staining at 72h after addition of CpG-miR-126 inhibitor (500 nm) in normal and CML BM LT-HSCs. The experiments were repeated twice using biologically independent samples with similar results. (o) Cy3 uptake in BM, LT-HSCs and ECs, as assessed at 16h by flow cytometry, from CML mice treated with one dose (5mg/kg, iv injection) of CpG-miR-126 inhibitor-cy3 (n=3 independent samples). (p,q) mir-126 expression in BM, LT-HSCs and ECs, as assessed by QPCR, from normal (p) and CML mice (q) treated with CpG-miR-126 inhibitor (5mg/kg/day, iv, daily) for 3 days (n=4 mice in each group). Comparison between groups was performed by two-tailed, unpaired Student's t-test. P values <0.05 were considered significant. Results shown represent mean ± SEM. p < 0.05, p < 0.01, p <

15 Supplementary Figure 7 a b c d e f g h i j mcd45- PE-Cy7 scrrna Inhibiitor scrrna+nil Inhibitor+NIL hcd38-apc 20% 12.5% hcd45-percp-cy5.5 15% 5.5% hcd34-fitc n 10% 5.9% 8% 5.2% BCR/ABL CML LSC mir-126 Endothelial cells mir-126 Normal HSC mir-126 k l m hcd90-pe Cell cycling Self-renewal exosomes exosomes Cell cycling Self-renewal CML LSC mir-126 CpG-miR-126 inhibitor Normal HSC mir-126 Cell cycling Apoptosis Self-renewal TKI Cell cycling Self-renewal

16 Supplementary Figure 7, CpG-miR-126 inhibitor in combination with Nilotinib enhances in vivo targeting of CML LSCs (a-f) red blood cell (RBC) (a), WBC (b) and platelet (PLT) (c) counts in PB and mononuclear cell (d), LT-HSC (e) and EC (f) counts in BM from WT B6 mice treated with CpG-scrRNA (scrrna) or CpG-miR-126 inhibitor (inhibitor, 5mg/kg/day i.v. 4 times a week) for 3 weeks (n=8 mice for each group). (g-i) donor cell engraftment in PB every 4 weeks (g) and in BM and spleen at 16 weeks (h) and donor LT-HSC number in BM (i) from CD45.1 recipient mice transplanted with BM cells (3x10 5 /mouse, n=9 for each group) from treated CD45.2 B6 mice from a-f. (j) Reprehensive plots of human CD45 +, CD45 + CD34 + CD38 - and CD45 + CD34 + CD38 - CD90 + cell engraftment in the BM of the NSG-SGM3 mice transplanted with human CP CML Lin - CD34 + cells (n=56) and then treated with scrrna (5mg/kg, i.v. 4 times a week), inhibitor (5mg/kg i.v. 4 times a week), scrrna + NIL (50mg/kg, daily by oral gavage), or inhibitor + NIL for 3 weeks (n=14 for each group). (k) BCR-ABL levels in BM cells by QPCR (n=6 independent samples) (k), mir-126 expression in BM ECs (n=4 independent samples) (l) and in selected Sca-1 + and Sca-1 - BM ECs (n=4 independent samples) (m) from a cohort of CML mice treated as above with scrrna, inhibitor, scrrna+nil, or inhibitor+nil respectively, for 3 weeks. (n) Schematic model of the role of mir-126 in modulating quiescence and self-renewal of CML LSCs through a well orchestrated interplay between the hematopoietic compartment and the microenvironment in the BM niche. Comparison between groups was performed by two-tailed, unpaired Student's t-test. P values <0.05 were considered significant. Results shown represent mean ± SEM. p < 0.05, p < 0.01, p <

17 Supplementary Figure 8

18 Supplementary Figure 8, Full-length gels and blots with molecular weight standards for Fig. 3d, e, g.

19 Supplementary Figure 9

20 Supplementary Figure 9, Full-length gels and blots with molecular weight standards for Fig. 3h, j, n.

21 Supplementary Figure 10

22 Supplementary Figure 10, Full-length gels and blots with molecular weight standards for Fig. 3m, q, Supplementary Fig. 3c, 5h, k, m, p.

23 Supplementary Figure 11 Supplementary Figure 11, Gating strategy for flow cytometry analysis. All samples were FSC-A and SSC-A gated, followed by FSC-A/FSC-H gating to select singlet cells. DAPI negative cells were then gated for subsequent relevant gating, shown in the main figures or supplementary figures.

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