Diagnostic approach to the evaluation of myeloid malignancies following CAR T-cell therapy in B-cell acute lymphoblastic leukemia.
Diagnostic approach to the evaluation of myeloid malignancies following CAR T-cell therapy in B-cell acute lymphoblastic leukemia.
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DOI：
10.1136/jitc-2020-001563
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发表时间：
2020-11
影响因子：
10.9
通讯作者：
Shah NN
中科院分区：
文献类型：
--
作者：
Mo G;Wang HW;Talleur AC;Shahani SA;Yates B;Shalabi H;Douvas MG;Calvo KR;Shern JF;Chaganti S;Patrick K;Song Y;Fry TJ;Wu X;Triplett BM;Khan J;Gardner RA;Shah NN
针对B细胞急性淋巴细胞白血病（B-ALL）的免疫策略有效诱导缓解;然而，疾病复发仍然是一个挑战。由于潜在的抗原丢失、抗原减少、谱系转换或继发性或治疗相关恶性肿瘤的发展，后续白血病的表型和表现可能难以确定。我们报告两例多次复发/难治性B-ALL患者，嵌合抗原受体T细胞治疗后，发展为骨髓恶性肿瘤。在第一个病例中，一个骨髓肉瘤发生在一个有骨髓增生异常综合征病史的病人身上。在第二种情况下，发生了两个不同的事件。第1起事件为既往接受过造血干细胞移植的患者发生的供体源性骨髓增生异常综合征伴7号单体。该患者继续表现出其原始B-ALL谱系转换为模糊谱系T/髓性急性白血病。随着新型免疫策略领域的快速发展，复发和/或后续肿瘤的评估变得越来越复杂。凭借这些独特的复杂情况下，我们提供了一个框架，评估复发或演变的后续恶性肿瘤抗原靶向免疫治疗。
Immunotherapeutic strategies targeting B-cell acute lymphoblastic leukemia (B-ALL) effectively induce remission; however, disease recurrence remains a challenge. Due to the potential for antigen loss, antigen diminution, lineage switch or development of a secondary or treatment-related malignancy, the phenotype and manifestation of subsequent leukemia may be elusive. We report on two patients with multiply relapsed/refractory B-ALL who, following chimeric antigen receptor T-cell therapy, developed myeloid malignancies. In the first case, a myeloid sarcoma developed in a patient with a history of myelodysplastic syndrome. In the second case, two distinct events occurred. The first event represented a donor-derived myelodysplastic syndrome with monosomy 7 in a patient with a prior hematopoietic stem cell transplantation. This patient went on to present with lineage switch of her original B-ALL to ambiguous lineage T/myeloid acute leukemia. With the rapidly evolving field of novel immunotherapeutic strategies, evaluation of relapse and/or subsequent neoplasms is becoming increasingly more complex. By virtue of these uniquely complex cases, we provide a framework for the evaluation of relapse or evolution of a subsequent malignancy following antigen-targeted immunotherapy.
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影响因子：
20.3
作者：
Gardner, Rebecca A.;Finney, Olivia;Jensen, Michael C.
通讯作者：
Jensen, Michael C.
影响因子：
2.6
作者：
Demosthenous, Christos;Lalayanni, Chrysavgi;Anagnostopoulos, Achilles
通讯作者：
Anagnostopoulos, Achilles
DOI：
10.1038/s41571-019-0184-6
发表时间：
2019-06
期刊：
Nature reviews. Clinical oncology
影响因子：
--
作者：
Shah NN;Fry TJ
通讯作者：
Fry TJ
异基因造血干细胞移植后急性白血病髓外复发：急性粒细胞白血病与急性淋巴细胞白血病的不同特点
影响因子：
4.3
作者：
Ge, Ling;Ye, Fan;Tang, Xiaowen
通讯作者：
Tang, Xiaowen
影响因子：
20.3
作者：
Gardner, Rebecca;Wu, David;Turtle, Cameron J.
通讯作者：
Turtle, Cameron J.