Essential Site Maintenance: Authorea-powered sites will be updated circa 15:00-17:00 Eastern on Tuesday 5 November.
There should be no interruption to normal services, but please contact us at [email protected] in case you face any issues.

loading page

Emergence of a prominent myeloid clone in a ZNF384-rearranged B-cell precursor acute lymphoblastic leukaemia post-corticosteroid pre-phase therapy.
  • +5
  • Alpeshkumar Kapadia,
  • Sreejesh Sreedharanunni,
  • Safal Muhammed,
  • Indrani Karmakar,
  • Sonia Rana,
  • Prashant Sharma,
  • Man Updesh Sachdeva,
  • Amita Trehan
Alpeshkumar Kapadia
Post Graduate Institute of Medical Education and Research

Corresponding Author:[email protected]

Author Profile
Sreejesh Sreedharanunni
Post Graduate Institute of Medical Education and Research
Author Profile
Safal Muhammed
Post Graduate Institute of Medical Education and Research
Author Profile
Indrani Karmakar
Post Graduate Institute of Medical Education and Research
Author Profile
Sonia Rana
Post Graduate Institute of Medical Education and Research
Author Profile
Prashant Sharma
Post Graduate Institute of Medical Education and Research
Author Profile
Man Updesh Sachdeva
Post Graduate Institute of Medical Education and Research
Author Profile
Amita Trehan
Post Graduate Institute of Medical Education and Research
Author Profile

Abstract

A 2-year-old girl with TCF3-ZNF384 re-arranged standard-risk B-cell precursor acute lymphoblastic leukaemia (BCP-ALL) showed an apparent lineage-switch to predominantly myeloid blasts following 7-days of corticosteroid therapy. ZNF384-re-arranged leukemias are increasingly recognized to present either as mixed-phenotype acute leukemia or as BCP-ALL with pro-B immunophenotype. Lineage switch is a rare phenomenon described at relapse or following CAR-T-cell therapy previously mostly in KMT2A re-arranged leukemias; and now, also in ZNF384-rearranged patients. It is previously unreported in any patient after pre-phase corticosteroid therapy. Hematologists should be aware of this distinct emerging entity among leukemias with multi-lineage differentiation potential.
Dec 2020Published in Pediatric Blood & Cancer volume 67 issue 12. 10.1002/pbc.28513