Zoghbi Annabelle, Zur Stadt Udo, Winkler Beate, Müller Ingo, Escherich Gabriele
Clinic of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Center of Diagnostics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Pediatr Blood Cancer. 2017 Nov;64(11). doi: 10.1002/pbc.26594. Epub 2017 Apr 28.
Blinatumomab is a bispecific T-cell engaging αCD19 antibody used in refractory or relapsed B-cell precursor acute lymphoblastic leukemia (ALL). Recently, lineage switch to a myeloid phenotype has been described following CD19 targeting treatment in three pediatric patients with mixed lineage leukemia (MLL) rearranged ALL. We report the case of a female who received blinatumomab for a first relapse of ALL without MLL alterations. She suffered from a second relapse early after hematopoietic stem cell transplantation and was treated with blinatumomab again. During this treatment, the leukemia lost CD19 expression as well as nearly all other B-cell markers, while still harboring the initial minimal residual disease marker, and switched to a myeloid phenotype.
博纳吐单抗是一种用于难治性或复发性B细胞前体急性淋巴细胞白血病（ALL）的双特异性T细胞衔接αCD19抗体。最近，在三名患有混合谱系白血病（MLL）重排ALL的儿科患者接受CD19靶向治疗后，出现了向髓系表型的谱系转换。我们报告了一名女性患者的病例，她因无MLL改变的ALL首次复发接受了博纳吐单抗治疗。她在造血干细胞移植后不久出现第二次复发，并再次接受博纳吐单抗治疗。在这次治疗期间，白血病失去了CD19表达以及几乎所有其他B细胞标志物，同时仍保留最初的微小残留病标志物，并转换为髓系表型。
