https://scholars.lib.ntu.edu.tw/handle/123456789/631237
標題: | Lineage switch of KMT2A-rearranged adult B-lineage acute lymphoblastic leukemia following bispecific T-cell engager and monoclonal antibody therapy | 作者: | Wu, Jia-Rong Shih, Pei-Chun Li, Ching Chao, Hsiao-Ling Wang, Hsiao-Chun Chiang, Yi-Mei Liu, Yu-Jung SZU-CHUN HSU CHI-YUAN YAO Chen, Lo-Ho CHIEN-CHIN LIN HWEI-FANG TIEN WEN-CHIEN CHOU |
關鍵字: | B-acute lymphoblastic leukemia; KMT2A rearrangement; Bispecific T-cell engager; lineage switch; Mixed phenotype acute leukemia | 公開日期: | 2023 | 出版社: | SPRINGER HEIDELBERG | 來源出版物: | JOURNAL OF HEMATOPATHOLOGY | 摘要: | Adult B-lineage acute lymphoblastic leukemia (B-ALL) with t(4;11)(q21;q23) is very rare. It is characterized by mixed-lineage leukemia and has the potential for lineage switching during the treatment course. We report the disease course of a patient with B-ALL with t(4;11)(q21;q23) to demonstrate that close monitoring of cell morphology and immunophenotyping is necessary to capture the lineage switch at an early stage. Cell morphology, immunophenotyping, and cytogenetics were used to evaluate the patient’s disease status. A 36-year-old woman was diagnosed with B-ALL with t(4;11)(q21;q23), which encodes the KMT2A::AFF1 fusion. After the initial induction chemotherapy, her disease remained refractory, and the patient received salvage immunotherapy with blinatumomab and inotuzumab ozogamicin. However, the ALL did not respond. Repeated bone marrow examinations unexpectedly revealed the emergence of a major population of monoblasts, in addition to a minor population of the original B lymphoblasts. The patient was diagnosed with disease evolution from B-ALL to mixed-phenotype acute leukemia (MPAL, B/myeloid). We present this case to highlight the potential of KMT2A-rearranged B-ALL to undergo lineage switch following B-cell targeted therapy. Patients with this kind of B-ALL should therefore be closely monitored to capture potential changes in the nature of the disease and prompt appropriate treatment. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/631237 | ISSN: | 1868-9256 | DOI: | 10.1007/s12308-023-00539-6 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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