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Variant acute promyelocytic leukaemia with novel NAB2::RARA fusion shows clinical all-trans retinoic acid and arsenic trioxide sensitivity Acute promyelocytic leukaemia (APL) is characterised by reciprocal translocation between the promyelocytic leukaemia ( I PML i ) gene at chromosome 15q24 and the retinoic acid receptor alpha ( I RARA i ) gene at chromosome 17q21. (E) Metaphase FISH using PML:RARA dual fusion translocation probe (Metasystems), which is negative for PML:RARA fusion but displays 3 RARA (green) signals, indicating the presence of a variant RARA translocation. [Extracted from the article]

Multi‐parametric flow cytometry (MFC) has a well‐established role in measurable residual disease (MRD) monitoring in patients with B‐lymphoblastic leukemia (B‐ALL). However, the optimal time‐point (TP) for early MRD testing and associated prognostic impact remain undefined in adult B‐ALL patients receiving Hyper‐CVAD induction chemotherapy. To evaluate the utility of MRD analysis after one cycle (TP1) in comparison to MRD analysis after two cycles (TP2) of induction treatment with Hyper‐CVAD chemotherapy, we studied 49 adult B‐ALL patients over a 10‐year period (2010–2020) who had available bone marrow samples for morphological and MFC MRD assessments at the two separate TPs. Median times to TP1 and TP2 relative to start of treatment were 21 and 45 days, respectively. When censored at transplant, achievement of MRD negativity at TP1 was not associated with a statistically significant improvement in either event‐free survival (EFS) (p =.426) or overall survival (OS) (p =.335) when compared to patients with MRD positivity. In contrast, achieving MRD negativity at TP2 was associated with a statistically significant improvement in both EFS (p = ·005) and OS (p =.047) over patients who remained MRD positive. Multivariate analysis demonstrated that KMT2A‐rearrangement and MRD positivity at TP2 were the only significant predictors of outcome, correlating with worse EFS and OS. Therefore, in the absence of residual morphologic disease, MRD analysis after one cycle of Hyper‐CVAD induction chemotherapy did not provide additional benefit with regard to risk stratification or correlation with survival outcomes when compared to MRD testing after two cycles of Hyper‐CVAD in adult B‐ALL patients. [ABSTRACT FROM AUTHOR]

Although reactive large granular lymphocytosis due to diverse etiologies is not an uncommon finding in clinical practice, isolated natural killer (NK)‐cell lymphocytosis is unusual and its association with immunotherapy has not been described thus far. We provide a brief analysis of a patient with this unique hematological corollary of immunotherapy being increasingly used in the setting of both solid organ and hematological malignancies, and highlight this as an additional differential to consider in the diagnosis of large granular lymphocytosis. Also explored is the importance of recognizing and monitoring the potential hematological manifestations of experimental immunotherapies, as well as the possible implicated mechanisms of action. It is hypothesized that quantification of large granular lymphocytosis may potentially be used as a surrogate marker of therapeutic efficacy in this setting. [ABSTRACT FROM AUTHOR]