Horgan Claire, Kartsios Charalampos, Nikolousis Emmanouil, Shankara Paneesha, Kishore Bhuvan, Lovell Richard, Murthy Vidhya, Rudzki Zbigniew, Dyer Sara, Holtom Pam, Thompson Gillian, Kaparou Maria, Xenou Evgenia, Lloyd Rebecca, Venkatadasari Indrani, Kanellopoulos Alexandros Georgios
University Hospitals Birmingham NHS Foundation Trust, Heartlands Hospital.
West Midlands Regional Genetics Laboratory, Birmingham Women's and Children's NHS Foundation Trust.
Leuk Res Rep. 2020 Jun 18;14:100213. doi: 10.1016/j.lrr.2020.100213. eCollection 2020.
Herein we present a female patient aged 61 with Philadelphia negative acute lymphoblastic leukaemia demonstrating near haploid karyotype and abnormal TP53 expression at diagnosis, who relapsed with lineage switch as Acute Monocytic Leukemia post allogeneic stem cell transplantation. Molecular analysis established that both neoplasms were derived from the same founder clone. The leukemic lineage switch phenomenon has recently re-attracted interest as mechanism of leukemic evasion post treatment with chimeric antigen receptor T-cells but there is paucity of data on its presence post allograft or following novel antibody treatments such as Inotuzumab Ozogamicin or Blinatumomab. Our proposition for cancer research is that near haploidy in ALL could be linked to leukemic stem cell plasticity evading stem cell transplantation and other immunotherapy approaches.
在此，我们报告一名61岁的女性费城阴性急性淋巴细胞白血病患者，其诊断时显示近单倍体核型且TP53表达异常，在异基因干细胞移植后复发并发生谱系转换为急性单核细胞白血病。分子分析确定这两种肿瘤均源自同一个原始克隆。白血病谱系转换现象最近作为嵌合抗原受体T细胞治疗后白血病逃逸的机制再次引起关注，但关于其在同种异体移植后或新型抗体治疗（如奥英妥珠单抗或博纳吐单抗）后出现的数据很少。我们对癌症研究的建议是，急性淋巴细胞白血病中的近单倍体可能与白血病干细胞可塑性有关，从而逃避干细胞移植和其他免疫治疗方法。
