Multiple Lineage Switches in KMT2A Rearranged Infant Leukemia,
Responsive to Combination Therapy with CPX-351 and Inotuzumab
Abstract
Rearrangements of the KMT2A gene are characteristic of infantile
acute lymphoblastic leukemia (ALL) and are associated with increased
lineage plasticity and resistance to therapy. Here, we describe the case
of a 9-month-old infant with infantile ALL who experienced multiple
immunophenotypic switches in her leukemia throughout therapy and
ultimately achieved remission with the combination of CPX-351 and
Inotuzumab. This case highlights the unique clinical challenges
infantile ALL poses on monitoring therapeutic response with current
methods of measuring minimal residual disease as well as the challenges
in treating infantile B-ALL.