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
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 re...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2019/7394619 |
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| author | Rui R. He Zacharia Nayer Matthew Hogan Raymund S. Cuevo Kimberly Woodward David Heyer Christine A. Curtis Jess F. Peterson |
| author_facet | Rui R. He Zacharia Nayer Matthew Hogan Raymund S. Cuevo Kimberly Woodward David Heyer Christine A. Curtis Jess F. Peterson |
| author_sort | Rui R. He |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-9ed395d9df0c4d4f9704b165b8be6a8a |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-9ed395d9df0c4d4f9704b165b8be6a8a2025-08-20T03:38:40ZengWileyCase Reports in Hematology2090-65602090-65792019-01-01201910.1155/2019/73946197394619Immunotherapy- (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 LeukemiaRui R. He0Zacharia Nayer1Matthew Hogan2Raymund S. Cuevo3Kimberly Woodward4David Heyer5Christine A. Curtis6Jess F. Peterson7Department of Pathology, Inova Fairfax Hospital, Falls Church, VA, USASchool of Medicine, George Washington University, Washington, DC, USASchool of Medicine, Virginia Commonwealth University, Richmond, VA, USAInova Schar Cancer Institute, Inova Fairfax Hospital, Falls Church, VA, USADepartment of Pathology, Inova Fairfax Hospital, Falls Church, VA, USAInova Schar Cancer Institute, Inova Fairfax Hospital, Falls Church, VA, USADepartment of Cytogenetics, Quest Diagnostics Nichols Institute, Chantilly, VA, USADivision of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USAThe 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.http://dx.doi.org/10.1155/2019/7394619 |
| spellingShingle | Rui R. He Zacharia Nayer Matthew Hogan Raymund S. Cuevo Kimberly Woodward David Heyer Christine A. Curtis Jess F. Peterson 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 Reports in Hematology |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | http://dx.doi.org/10.1155/2019/7394619 |
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