Pediatric T-Lymphoblastic Leukemia With Aberrant B-Cell Marker Expression: A Potential Role for Targeted Therapy.

BACKGROUND

Expression of B-cell antigens is rare in T-lymphoblastic leukemia/lymphoma (T-LBLL), and the significance is uncertain.

OBJECTIVE AND

METHODS

We present a pediatric case of acute leukemia characterized by the expression of T-cell markers and CD19, as determined by multicolor flow cytometry (MFC). Next-generation sequencing (NGS) revealed a SET::NUP214 gene fusion. The patient was treated with conventional intensive acute lymphoblastic leukemia (ALL) therapy. The end-of-induction evaluations showed significant residual disease.

RESULTS

While the patient failed high-risk T-LBLL induction therapy, blinatumomab followed by decitabine and venetoclax induced a morphologic remission. He then underwent a bone marrow stem cell transplant (BMSCT) and achieved a complete molecular remission.

CONCLUSIONS

This case illustrated the importance of integrating MFC analysis with NGS data to provide individualized patient treatment.

TRIAL REGISTRATION: The authors have confirmed clinical trial registration is not needed for this submission.