CD19-negative relapse of pediatric B-cell precursor acute lymphoblastic leukemia following blinatumomab treatment.
Mejstríková E, Hrusak O, Borowitz MJ, Whitlock JA, Brethon B, Trippett TM, Zugmaier G, Gore L, von Stackelberg A, Locatelli F. Blood Cancer Journal. 2017 Dec 20;7(12):659. doi: 10.1038/s41408-017-0023-x. IF: 8.125
MUDr. Ester Mejstříková, Ph.D., Department of Paediatric Haematology and Oncology
CD19-negative relapse in B-cell precursor acute lymphoblastic leukemia (ALL) is observed as an infrequent event after chemotherapy and in up to 20% of patients after CD19-directed chimeric antigen receptor (CAR) T-cell immunotherapy. Patients with CD19-negative relapse usually have a poor prognosis. The mechanisms underlying CD19-negative relapse are not fully understood but are important to elucidate to further optimize CD19-directed immunotherapies. Monitoring blasts in patients with CD19-negative relapse by flow cytometry is challenging due to the lack of cell surface markers other than CD19 that are consistently expressed. Furthermore, CD19 is often used as a parameter to quantify minimal residual disease (MRD) and diagnose relapse. Potential markers to monitor persistent or recurrent leukemic blasts in an emergent CD19-negative blast population include B-cell lineage antigens (CD20, CD22, CD24, and intracellular [i]CD79a) and the common ALL antigen CD10.