Pena et al. (RBHH editorial, 2009) summarize a small clinical series and conclude JUNB promoter methylation is uncommon in CML and therefore unlikely to explain the frequently observed loss of JUNB expression in advanced phases; the literature is mixed because (1) early positive reports used limited cohorts and methods sensitive to sample prep, (2) larger methylome studies show complex, stage-dependent methylation changes, and (3) BCR‑ABL signaling and other epigenetic modulators (TET2/Fbxw7/lncRNAs) provide mechanistic alternatives supported by experimental data. Key limitation in Pena et al. — lack of direct JUNB expression measurements in the post‑transplant subgroup and small sample size (32 patients) — reduces mechanistic inference and reproducibility potential
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