1. Immune escape of B-cell lymphoblastic leukemic cells through a lineage switch to acute myeloid leukemia.
- Author
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Bełdzińska-Gądek K, Zarzycka E, Pastuszak K, Borman K, Lewandowski K, Zaucha JM, and Prejzner W
- Subjects
- Humans, Cell Transformation, Neoplastic genetics, Cell Transformation, Neoplastic immunology, Gene Rearrangement immunology, Histone-Lysine N-Methyltransferase genetics, Immunophenotyping, Precursor B-Cell Lymphoblastic Leukemia-Lymphoma diagnosis, Precursor B-Cell Lymphoblastic Leukemia-Lymphoma genetics, Precursor B-Cell Lymphoblastic Leukemia-Lymphoma immunology, Precursor B-Cell Lymphoblastic Leukemia-Lymphoma pathology, Tumor Escape genetics, Tumor Escape immunology, Cell Lineage genetics, Cell Lineage immunology, Leukemia, Myeloid, Acute diagnosis, Leukemia, Myeloid, Acute genetics, Leukemia, Myeloid, Acute immunology, Leukemia, Myeloid, Acute pathology, Myeloid-Lymphoid Leukemia Protein genetics
- Abstract
Acute leukemia (AL) with a lineage switch (LS) is associated with poor prognosis. The predisposing factors of LS are unknown, apart from KMT2A rearrangements that have been reported to be associated with LS. Herein, we present two cases and review all 104 published cases to identify risk factors for LS. Most of the patients (75.5%) experienced a switch from the lymphoid phenotype to the myeloid phenotype. Eighteen patients (17.0%) experienced a transformation from acute myelogenous leukemia (AML) to acute lymphoblastic leukemia (ALL). Forty-nine (46.2%) patients carried a KMT2A rearrangement. Most of the cases involved LS from B-cell ALL (B-ALL) to AML (59.4%), and 49 patients (46.2%) carried KMT2A -rearrangements. Forty patients (37.7%) received lineage-specific immunotherapy. Our findings suggest that the prevalence of KMT2A rearrangements together with the lineage-specific immunotherapy may trigger LS, which supports the thesis of the existence of leukemia stem cells that are capable of lymphoid or myeloid differentiation.
- Published
- 2024
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