Blinatumomab-Related Lineage Switch of KMT2A/AFF1-Rearranged B-Lymphoblastic Leukemia to B/Myeloid Mixed-Phenotype Acute Leukemia and Myeloid Sarcoma Causing Spinal Cord Compression.

ABSTRACT: Blinatumomab is a promising monoclonal antibody therapeutic for the treatment of relapsed or refractory B-cell precursor acute lymphoblastic leukemia (B-ALL). However, it has been associated with lineage switch in acute leukemia, particularly in cases of KMT2A-rearranged B-ALL, which carries a poor prognosis. While most lineage switch events present as acute myeloid leukemia (AML), rare cases may manifest as myeloid sarcoma. In the current report, we describe the development of myeloid sarcoma following blinatumomab treatment in a patient with refractory KMT2A-rearranged B-ALL. The patient, a 19-year-old African American male with primary Philadelphia chromosome-negative B-ALL, was initially treated with a pediatric-inspired chemotherapy regimen. He achieved pathologically morphologic remi

SUBMITTER: Fan X 

PROVIDER: S-EPMC12668854 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature