Abstract
Treatment options for relapsed or refractory B-lymphoblastic leukaemia (r/r B-ALL) are limited and the prognosis of these patients remains dismal, but novel immunotherapeutic options such as the anti-CD22 antibody–drug-conjugate Inotuzumab-Ozogamicin (InO) have improved outcomes in these patients. Flow cytometry is essential to assess antigen-expression prior to treatment initiation of antigen-directed immunotherapies. Here, we present flow cytometric and clinical data of three adult patients with r/r B-ALL who failed treatment with InO associated with reduced or lost antigen-expression. In addition, we present comparative data on two different diagnostic CD22-specific antibody clones that exhibit significant differences in staining intensities.
Highlights
The prognosis of patients with refractory B-lymphoblastic leukaemia and those with early recurrence after chemotherapy (r/r B-ALL) is poor and treatment options are limited
Diagnosis and risk-stratification of lymphoblastic leukaemia rely on cytomorphology, cytogenetics, molecular genetics and immunophenotyping
The CD22 antigen is restricted to B-cells and has been described to be expressed in the vast majority of B-ALL, but the intensity of expression can vary significantly among individual patients [1, 7, 8]
Summary
The prognosis of patients with refractory B-lymphoblastic leukaemia and those with early recurrence after chemotherapy (r/r B-ALL) is poor and treatment options are limited. Options for salvage-therapy include the anti-CD22 immunotherapeutic Inotuzumab-Ozogamicin (InO). This antibody–drug conjugate has shown superior rates of complete remissions (CR) and improved overall survival (OS) compared to intensive salvage-chemotherapy protocols in r/r B-ALL [1]. InO is a promising therapeutic option for combination treatments and is currently being
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