[KMT2A-rearranged acute lymphoblastic leukemia with lineage switch following relapse: a case report and literature review].
- 1Senior Department of Hematology, Chinese PLA General Hospital, Beijing 100071, China.
Abstract
To enhance the understanding of lineage switch (LS), we retrospectively analyzed the clinical data of a patient with KMT2A-rearranged acute lymphoblastic leukemia (ALL) who underwent a LS at relapse and reviewed the relevant literature. The patient, a 23-year-old woman, was initially diagnosed with ALL (KMT2A::AFF1-positive). She experienced a relapse during consolidation chemotherapy and achieved a second remission following chemotherapy containing blinatumomab, subsequently bridging to allogeneic stem cell transplantation. Approximately 2 months after transplantation, extensive extramedullary relapse occurred. Immunohistochemical analysis of the extramedullary mass revealed a partial loss of CD19 expression and emergence of MPO expression, whereas the KMT2A rearrangement was retained. After receiving CD19-CAR-T therapy, the patient experienced another extramedullary relapse, at which time complete loss of CD19 expression and positivity for MPO were observed, leading to a diagnosis of myeloid sarcoma. Ultimately, the family opted to discontinue treatment and the patient was discharged to receive care locally. Following antigen-targeted immunotherapy, LS, as a potential mechanism of drug resistance and adaptation, warrants increased clinical attention.
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BibTeX
@article{qiao2026kmt2arearranged,
title = {{[KMT2A-rearranged acute lymphoblastic leukemia with lineage switch following relapse: a case report and literature review].}},
author = {Z Q Qiao and Y P Shi and L D Hu},
journal = {Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi},
year = {2026},
month = aug,
doi = {10.3760/cma.j.cn121090-20260228-00114},
url = {https://europepmc.org/article/MED/42851184},
note = {CC BY},
}
RIS
TY - JOUR
TI - [KMT2A-rearranged acute lymphoblastic leukemia with lineage switch following relapse: a case report and literature review].
AU - Z Q Qiao
AU - Y P Shi
AU - L D Hu
PY - 2026
DA - 2026/08/01
JO - Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi
DO - 10.3760/cma.j.cn121090-20260228-00114
UR - https://europepmc.org/article/MED/42851184
AB - To enhance the understanding of lineage switch (LS), we retrospectively analyzed the clinical data of a patient with KMT2A-rearranged acute lymphoblastic leukemia (ALL) who underwent a LS at relapse and reviewed the relevant literature. The patient, a 23-year-old woman, was initially diagnosed with ALL (KMT2A::AFF1-positive). She experienced a relapse during consolidation chemotherapy and achieved a second remission following chemotherapy containing blinatumomab, subsequently bridging to allogeneic stem cell transplantation. Approximately 2 months after transplantation, extensive extramedullary relapse occurred. Immunohistochemical analysis of the extramedullary mass revealed a partial loss of CD19 expression and emergence of MPO expression, whereas the KMT2A rearrangement was retained. After receiving CD19-CAR-T therapy, the patient experienced another extramedullary relapse, at which time complete loss of CD19 expression and positivity for MPO were observed, leading to a diagnosis of myeloid sarcoma. Ultimately, the family opted to discontinue treatment and the patient was discharged to receive care locally. Following antigen-targeted immunotherapy, LS, as a potential mechanism of drug resistance and adaptation, warrants increased clinical attention.
SN - 0253-2727
SN - 2707-9740
ER -