Premium
Lineage Switch in MLL‐Rearranged Infant Leukemia Following CD19‐Directed Therapy
Author(s) -
Rayes Ahmad,
McMasters Richard L.,
O'Brien Maureen M.
Publication year - 2016
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25953
Subject(s) - blinatumomab , medicine , lineage (genetic) , myeloid leukemia , leukemia , lymphoblast , cancer research , cd19 , myeloid , acute lymphocytic leukemia , bone marrow , immunology , lymphoblastic leukemia , antibody , biology , gene , genetics , cell culture
Rearrangements of the mixed lineage leukemia (MLL) gene occur frequently in infants with both acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Conversions of leukemia cell lineage are rare, but occur most commonly in the setting of MLL‐rearrangement. Blinatumomab is a bidirectional antibody targeting CD19 with significant activity in relapsed B‐precursor ALL. We report an infant with ALL with t(4;11)(q21;q23) refractory to cytotoxic chemotherapy who was treated with blinatumomab. Following rapid initial clearance of peripheral lymphoblasts, bone marrow evaluation demonstrated a leukemic lineage switch to CD19‐negative monoblastic AML. Complete remission was achieved with myeloid‐directed chemotherapy.