1
|
Ducassou S, Abou Chahla W, Duployez N, Halfon-Domenech C, Brethon B, Poirée M, Adam de Beaumais T, Lemaître L, Sirvent N, Petit A. [SFCE harmonization workshops: Neonatal acute myeloid leukemia]. Bull Cancer 2024; 111:513-524. [PMID: 38503585 DOI: 10.1016/j.bulcan.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/28/2023] [Accepted: 12/07/2023] [Indexed: 03/21/2024]
Abstract
Neonatal acute myeloid leukemias (AML) occurred within the first 28 days of life and constitute only a small proportion of all AL. They are distinguished from leukemias of older children by their clinical presentation, which frequently includes cutaneous localizations ("blueberry muffin rash syndrome") and a leukocytosis above 50 ×109/L. This proliferation may be transient, causing a transient leukemoid reaction in a background of constitutional trisomy 21 ("Transient Abnormal Myelopoieseis" or TAM) or Infantile Myeloproliferative Disease in the absence of constitutional trisomy 21 ("Infantile Myeloproliferative Disease" or IMD). In cases of true neonatal AML, the prognosis of patients is poor. Overall survival is around 35 % in the largest historical series. This poor prognosis is mainly due to the period of onset of this pathology making the use of chemotherapy more limited and involving many considerations, both ethical and therapeutic. The objective of this work is to review this rare pathology by addressing the clinical, biological, therapeutic and ethical particularities of patients with true neonatal AML or transient leukemoid reactions occurring in a constitutional trisomy 21 (true TAM) or somatic background (IMD).
Collapse
Affiliation(s)
- Stéphane Ducassou
- Service d'hématologie et d'oncologie pédiatrique, CHU de Bordeaux, Bordeaux, France
| | | | | | - Carine Halfon-Domenech
- Service d'hématologie pédiatrique, institut d'hématologie et d'oncologie pédiatrique, hospices civils de Lyon, université Lyon 1, Lyon, France
| | - Benoît Brethon
- Service d'hématologie pédiatrique, hôpital Robert-Debré, AP-HP, Paris, France
| | - Marilyne Poirée
- Service d'hématologie et d'oncologie pédiatrique, CHU de Nice, Nice, France
| | | | - Laurent Lemaître
- Service d'hématologie et oncologie pédiatrique, CHU de Montpellier, Montpellier, France
| | - Nicolas Sirvent
- Service d'hématologie et oncologie pédiatrique, CHU de Montpellier, Montpellier, France
| | - Arnaud Petit
- Service d'hématologie et oncologie pédiatrique, hôpital Armand-Trousseau, AP-HP, Sorbonne université, Paris, France
| |
Collapse
|
2
|
Goubeau L, Bally C, Borgel D, Alby-Laurent F, Petit A, Frenzel L, Lasne D, Harroche A. Emicizumab and asparaginase, A first experience to share. Haemophilia 2024; 30:561-563. [PMID: 38240017 DOI: 10.1111/hae.14935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/23/2023] [Accepted: 12/23/2023] [Indexed: 03/14/2024]
Affiliation(s)
- Laurie Goubeau
- Laboratoire d'Hématologie Biologique, AP-HP, Hôpital Necker Enfants Malades, Paris, France
| | - Cécile Bally
- Centre de Traitement de l'Hémophilie, AP-HP, Hôspital Necker Enfants Malades, Paris, France
| | - Delphine Borgel
- Laboratoire d'Hématologie Biologique, AP-HP, Hôpital Necker Enfants Malades, Paris, France
- HITh, UMR_S 1176, INSERM, Univ. Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Fanny Alby-Laurent
- Service d'hématologie pédiatrique, AP-HP, Hôpital Trousseau, Paris, France
| | - Arnaud Petit
- Service d'hématologie pédiatrique, AP-HP, Hôpital Trousseau, Paris, France
| | - Laurent Frenzel
- Centre de Traitement de l'Hémophilie, AP-HP, Hôspital Necker Enfants Malades, Paris, France
| | - Dominique Lasne
- Laboratoire d'Hématologie Biologique, AP-HP, Hôpital Necker Enfants Malades, Paris, France
- HITh, UMR_S 1176, INSERM, Univ. Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Annie Harroche
- Centre de Traitement de l'Hémophilie, AP-HP, Hôspital Necker Enfants Malades, Paris, France
| |
Collapse
|
3
|
Zhou T, Curry CV, Khanlari M, Shi M, Cui W, Peker D, Chen W, Wang E, Gao J, Shen Q, Xie W, Jelloul FZ, King RL, Yuan J, Wang X, Zhao C, Obiorah IE, Courville EL, Nomura E, Cherian S, Xu ML, Burack WR, Liu HX, Jabbour EJ, Takahashi K, Wang W, Wang SA, Khoury JD, Medeiros LJ, Hu S. Genetics and pathologic landscape of lineage switch of acute leukemia during therapy. Blood Cancer J 2024; 14:19. [PMID: 38272888 PMCID: PMC10810851 DOI: 10.1038/s41408-024-00983-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/27/2024] Open
Affiliation(s)
- Ting Zhou
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Choladda V Curry
- Department of Pathology & Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Mahsa Khanlari
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Min Shi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Wei Cui
- Department of Pathology, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Deniz Peker
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Weina Chen
- Department of Pathology, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Endi Wang
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Juehua Gao
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Qi Shen
- Department of Pathology, AdventHealth-Orlando, Orlando, FL, USA
| | - Wei Xie
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Fatima Z Jelloul
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rebecca L King
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Ji Yuan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Xiaoqiong Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chen Zhao
- Department of Pathology, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Ifeyinwa E Obiorah
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Elizabeth L Courville
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Eric Nomura
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Sindhu Cherian
- Department of Laboratory Medicine & Pathology, University of Washington Medical Center, Seattle, WA, USA
| | - Mina L Xu
- Department of Pathology, Yale University School of Medicine, New Haven, CT, USA
| | - W Richard Burack
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Hong-Xing Liu
- Molecular Medicine Center, Beijing Lu Daopei lnstitute of Hematology, Beijing, China
| | - Elias J Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Koichi Takahashi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wei Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joseph D Khoury
- Department of Pathology, Microbiology, and Immunology, University of Nebraska Medical Center, Omaha, NE, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| |
Collapse
|
4
|
Omer MH, Shafqat A, Ahmad O, Alkattan K, Yaqinuddin A, Damlaj M. Bispecific Antibodies in Hematological Malignancies: A Scoping Review. Cancers (Basel) 2023; 15:4550. [PMID: 37760519 PMCID: PMC10526328 DOI: 10.3390/cancers15184550] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/25/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Bispecific T-cell engagers (BiTEs) and bispecific antibodies (BiAbs) have revolutionized the treatment landscape of hematological malignancies. By directing T cells towards specific tumor antigens, BiTEs and BiAbs facilitate the T-cell-mediated lysis of neoplastic cells. The success of blinatumomab, a CD19xCD3 BiTE, in acute lymphoblastic leukemia spearheaded the expansive development of BiTEs/BiAbs in the context of hematological neoplasms. Nearly a decade later, numerous BiTEs/BiAbs targeting a range of tumor-associated antigens have transpired in the treatment of multiple myeloma, non-Hodgkin's lymphoma, acute myelogenous leukemia, and acute lymphoblastic leukemia. However, despite their generally favorable safety profiles, particular toxicities such as infections, cytokine release syndrome, myelosuppression, and neurotoxicity after BiAb/BiTE therapy raise valid concerns. Moreover, target antigen loss and the immunosuppressive microenvironment of hematological neoplasms facilitate resistance towards BiTEs/BiAbs. This review aims to highlight the most recent evidence from clinical trials evaluating the safety and efficacy of BiAbs/BiTEs. Additionally, the review will provide mechanistic insights into the limitations of BiAbs whilst outlining practical applications and strategies to overcome these limitations.
Collapse
Affiliation(s)
- Mohamed H. Omer
- School of Medicine, Cardiff University, Cardiff CF14 4YS, UK
| | - Areez Shafqat
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; (A.S.); (O.A.); (K.A.); (A.Y.)
| | - Omar Ahmad
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; (A.S.); (O.A.); (K.A.); (A.Y.)
| | - Khaled Alkattan
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; (A.S.); (O.A.); (K.A.); (A.Y.)
| | - Ahmed Yaqinuddin
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia; (A.S.); (O.A.); (K.A.); (A.Y.)
| | - Moussab Damlaj
- Department of Hematology & Oncology, Sheikh Shakhbout Medical City, Abu Dhabi P.O. Box 11001, United Arab Emirates;
- College of Medicine, Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates
| |
Collapse
|
5
|
Lee BJ, Griffin SP, Doh J, Chan A, O'Brien S, Jeyakumar D, Ciurea SO, Becker PS, Kongtim P. CD19-directed immunotherapy use in KMT2A-rearranged acute leukemia: A case report and literature review of increased lymphoid to myeloid lineage switch. Am J Hematol 2022; 97:E439-E443. [PMID: 36057135 DOI: 10.1002/ajh.26713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 08/26/2022] [Indexed: 01/31/2023]
Affiliation(s)
- Benjamin J Lee
- Department of Pharmacy, University of California Irvine Health, Orange, California, USA
| | - Shawn P Griffin
- Department of Pharmacy, University of California Irvine Health, Orange, California, USA.,Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, California, USA
| | - Jean Doh
- Department of Pharmacy, University of California Irvine Health, Orange, California, USA
| | - Alexandre Chan
- Department of Pharmacy, University of California Irvine Health, Orange, California, USA.,Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, Irvine, California, USA
| | - Susan O'Brien
- Department of Medicine, Division of Hematology/Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine Health, Orange, California, USA
| | - Deepa Jeyakumar
- Department of Medicine, Division of Hematology/Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine Health, Orange, California, USA
| | - Stefan O Ciurea
- Department of Medicine, Division of Hematology/Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine Health, Orange, California, USA
| | - Pamela S Becker
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
| | - Piyanuch Kongtim
- Department of Medicine, Division of Hematology/Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine Health, Orange, California, USA
| |
Collapse
|
6
|
Kurzer JH, Weinberg OK. To B- or not to B-: A review of lineage switched acute leukemia. Int J Lab Hematol 2022; 44 Suppl 1:64-70. [PMID: 35770493 DOI: 10.1111/ijlh.13923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/10/2022] [Indexed: 11/28/2022]
Abstract
Acute leukemia is a heterogeneous disorder of hematologic malignancies composed primarily of hematopoietic precursors that have acquired unregulated self-renewal and proliferation. Hematology classification systems typically divide these neoplasms into lymphoid (B- or T-) and myeloid-lineage subtypes, with therapy dependent upon this distinction. Infrequently, certain acute leukemias may undergo a complete lineage switch at relapse, subsequently complicating the diagnosis and treatment of these recurrent diseases. Transformation from B-lineage to myeloid lineage is the most common switch observed, and is frequently associated with a balanced 11q23 translocation, involving KMT2A. The mechanisms involved in the lineage-switch are unclear, but modern therapies targeting the B-cell-specific marker, CD19, have proven to promote this conversion as one means of treatment escape. Broadly speaking, therapy-mediated selection of alternate lineage-committed subclones derived from the same initial pluripotent progenitors, clonal evolution and reprogramming of lineage-committed blasts, and de novo clonally unrelated leukemias may account for the clinical impression of lineage switched acute leukemia during treatment. This review will explore the phenomenon and potential mechanisms of lineage transformation during the treatment of acute leukemia.
Collapse
Affiliation(s)
- Jason H Kurzer
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Olga K Weinberg
- Department of Pathology, UT Southwestern Medical Center, Dallas, Texas, USA
| |
Collapse
|
7
|
Liao W, Kohler ME, Fry T, Ernst P. Does lineage plasticity enable escape from CAR-T cell therapy? Lessons from MLL-r leukemia. Exp Hematol 2021; 100:1-11. [PMID: 34298117 PMCID: PMC8611617 DOI: 10.1016/j.exphem.2021.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/08/2021] [Accepted: 07/10/2021] [Indexed: 01/20/2023]
Abstract
The clinical success of engineered, CD19-directed chimeric antigen receptor (CAR) T cells in relapsed, refractory B-cell acute lymphoblastic leukemia (B-ALL) has generated great enthusiasm for the use of CAR T cells in patients with cytogenetics that portend a poor prognosis with conventional cytotoxic therapies. One such group includes infants and children with mixed lineage leukemia (MLL1, KMT2A) rearrangements (MLL-r), who fare much worse than patients with low- or standard-risk B-ALL. Although early clinical trials using CD19 CAR T cells for MLL-r B-ALL produced complete remission in most patients, relapse with CD19-negative disease was a common mechanism of treatment failure. Whereas CD19neg relapse has been observed across a broad spectrum of B-ALL patients treated with CD19-directed therapy, patients with MLL-r have manifested the emergence of AML, often clonally related to the B-ALL, suggesting that the inherent heterogeneity or lineage plasticity of MLL-r B-ALL may predispose patients to a myeloid relapse. Understanding the factors that enable and drive myeloid relapse may be important to devise strategies to improve durability of remissions. In this review, we summarize clinical observations to date with MLL-r B-ALL and generally discuss lineage plasticity as a mechanism of escape from immunotherapy.
Collapse
Affiliation(s)
- Wenjuan Liao
- Department of Pediatrics, Section of Hematology/Oncology/BMT, Center for Cancer and Blood Disorders, Children's Hospital Colorado, University of Colorado, Denver/Anschutz Medical Campus. Aurora, CO
| | - M Eric Kohler
- Department of Pediatrics, Section of Hematology/Oncology/BMT, Center for Cancer and Blood Disorders, Children's Hospital Colorado, University of Colorado, Denver/Anschutz Medical Campus. Aurora, CO
| | - Terry Fry
- Department of Pediatrics, Section of Hematology/Oncology/BMT, Center for Cancer and Blood Disorders, Children's Hospital Colorado, University of Colorado, Denver/Anschutz Medical Campus. Aurora, CO; Immunology Department and HI3 Initiative, University of Colorado, Denver/Anschutz Medical Campus. Aurora, CO
| | - Patricia Ernst
- Department of Pediatrics, Section of Hematology/Oncology/BMT, Center for Cancer and Blood Disorders, Children's Hospital Colorado, University of Colorado, Denver/Anschutz Medical Campus. Aurora, CO; Pharmacology Department, University of Colorado, Denver/Anschutz Medical Campus. Aurora, CO.
| |
Collapse
|
8
|
Du J, Chisholm KM, Tsuchiya K, Leger K, Lee BM, Rutledge JC, Paschal CR, Summers C, Xu M. Lineage Switch in an Infant B-Lymphoblastic Leukemia With t(1;11)(p32;q23); KMT2A/EPS15, Following Blinatumomab Therapy. Pediatr Dev Pathol 2021; 24:378-382. [PMID: 33749383 DOI: 10.1177/10935266211001308] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report a 6 month-old infant girl with t(1;11)(p32;q23), KMT2A/EPS15-rearranged B-acute lymphoblastic leukemia (B-ALL) that was refractory to traditional ALL-directed chemotherapy. Following administration of blinatumomab, she experienced lineage switch from B-ALL to acute myeloid leukemia (AML). Myeloid-directed chemotherapy resulted in clearance of AML by flow cytometry, though a residual CD19+ B-ALL population persisted (0.14%). Following bridging blinatumomab, the patient achieved B-ALL and AML remission, as measured by flow cytometry. The patient subsequently underwent allogeneic hematopoietic stem cell transplant. Unfortunately, she relapsed with CD19+ B-ALL one-month post-transplantation. Next generation sequencing study of IGH/IGL using ClonoSEQ® analysis detected 3 dominant sequences all present in her original B-ALL, lineage switched AML, and post-transplant relapsed B-ALL, though the latter showed an additional 4 sequences, three of which were present at low abundance in the original diagnostic sample. The presence of the same clones throughout her disease course suggests cellular reprogramming and differentiation following chemotherapy and immunotherapy. This is the first reported case of lineage switch of B-ALL with t(1;11) and also the first report of a lineage switch case that used ClonoSEQ® to define the clonality of the original B-ALL, lineage switched AML, and relapsed B-ALL.
Collapse
Affiliation(s)
- Jing Du
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington
| | - Karen M Chisholm
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington.,Department of Laboratories, Seattle Children's Hospital, Seattle, Washington
| | - Karen Tsuchiya
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington.,Department of Laboratories, Seattle Children's Hospital, Seattle, Washington
| | - Kasey Leger
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington.,Department of Pediatrics, University of Washington, Seattle, Washington
| | - Brittany M Lee
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington.,Department of Pediatrics, University of Washington, Seattle, Washington
| | - Joe C Rutledge
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington.,Department of Laboratories, Seattle Children's Hospital, Seattle, Washington
| | - Cate R Paschal
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington.,Department of Laboratories, Seattle Children's Hospital, Seattle, Washington
| | - Corinne Summers
- Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington.,Department of Pediatrics, University of Washington, Seattle, Washington.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Min Xu
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington.,Department of Laboratories, Seattle Children's Hospital, Seattle, Washington
| |
Collapse
|
9
|
He RR, Nayer Z, Hogan M, Cuevo RS, Woodward K, Heyer D, Curtis CA, Peterson JF. Immunotherapy- (Blinatumomab-) Related Lineage Switch of KMT2A/AFF1 Rearranged B-Lymphoblastic Leukemia into Acute Myeloid Leukemia/Myeloid Sarcoma and Subsequently into B/Myeloid Mixed Phenotype Acute Leukemia. Case Rep Hematol 2019; 2019:7394619. [PMID: 31885955 DOI: 10.1155/2019/7394619] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022] Open
Abstract
The presence of KMT2A/AFF1 rearrangement in B-lymphoblastic leukemia (B-ALL) is an independent poor prognostic factor and has been associated with higher rate of treatment failure and higher risk of linage switch under therapy. Blinatumomab has shown promising therapeutic results in refractory or relapsed B-ALL; however, it has potential risk of inducing lineage switch, especially in KMT2A/AFF1 rearranged B-ALL into acute myeloid leukemia and/or myeloid sarcoma. We report a 40-year-old female with KMT2A/AFF1-rearranged B-ALL that was refractory to conventional chemotherapy. Following administration of blinatumomab, she developed a breast mass proven to be myeloid sarcoma, in addition to bone marrow involvement by AML. Approximately six weeks after cessation of blinatumomab, a repeat bone marrow examination revealed B/myeloid MPAL.
Collapse
|
10
|
Stahl M, Tallman MS. Antibody-based therapy in acute leukemia - beware the risks. Leuk Lymphoma 2019; 60:1608-1609. [PMID: 31204877 DOI: 10.1080/10428194.2019.1608535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Maximilian Stahl
- a Department of Medicine , Memorial Sloan Kettering Cancer Center , Leukemia Service , New York , NY , USA
| | - Martin S Tallman
- a Department of Medicine , Memorial Sloan Kettering Cancer Center , Leukemia Service , New York , NY , USA
| |
Collapse
|