Karolina Bełdzińska-Gądek, Ewa Zarzycka, Krzysztof Pastuszak, Katarzyna Borman, Krzysztof Lewandowski, Jan M Zaucha, Witold Prejzner
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引用次数: 0
Abstract
Acute leukemia (AL) with a lineage switch (LS) is associated with poor prognosis. The predisposing factors of LS are unknown, apart from KMT2A rearrangements that have been reported to be associated with LS. Herein, we present two cases and review all 104 published cases to identify risk factors for LS. Most of the patients (75.5%) experienced a switch from the lymphoid phenotype to the myeloid phenotype. Eighteen patients (17.0%) experienced a transformation from acute myelogenous leukemia (AML) to acute lymphoblastic leukemia (ALL). Forty-nine (46.2%) patients carried a KMT2A rearrangement. Most of the cases involved LS from B-cell ALL (B-ALL) to AML (59.4%), and 49 patients (46.2%) carried KMT2A-rearrangements. Forty patients (37.7%) received lineage-specific immunotherapy. Our findings suggest that the prevalence of KMT2A rearrangements together with the lineage-specific immunotherapy may trigger LS, which supports the thesis of the existence of leukemia stem cells that are capable of lymphoid or myeloid differentiation.
伴有血系转换(LS)的急性白血病(AL)预后不良。除了有报道称KMT2A重排与LS相关外,LS的致病因素尚不清楚。在此,我们介绍了两个病例,并回顾了所有已发表的 104 个病例,以确定 LS 的风险因素。大多数患者(75.5%)经历了从淋巴表型向髓表型的转变。18名患者(17.0%)从急性髓性白血病(AML)转变为急性淋巴细胞白血病(ALL)。49名患者(46.2%)携带KMT2A重排。大多数病例涉及从B细胞ALL(B-ALL)到AML的LS(59.4%),49名患者(46.2%)携带KMT2A重排。40名患者(37.7%)接受了系特异性免疫治疗。我们的研究结果表明,KMT2A重排的发生率加上系特异性免疫疗法可能会引发LS,这支持了白血病干细胞能够进行淋巴或髓系分化的论点。
期刊介绍:
Leukemia & Lymphoma in its fourth decade continues to provide an international forum for publication of high quality clinical, translational, and basic science research, and original observations relating to all aspects of hematological malignancies. The scope ranges from clinical and clinico-pathological investigations to fundamental research in disease biology, mechanisms of action of novel agents, development of combination chemotherapy, pharmacology and pharmacogenomics as well as ethics and epidemiology. Submissions of unique clinical observations or confirmatory studies are considered and published as Letters to the Editor