{"doi":"10.1136/jitc-2020-001563","title":"Diagnostic approach to the evaluation of myeloid malignancies following CAR T-cell therapy in B-cell acute lymphoblastic leukemia","abstract":"Immunotherapeutic strategies targeting B-cell acute lymphoblastic leukemia (B-ALL) effectively induce remission; however, disease recurrence remains a challenge. Due to the potential for antigen loss, antigen diminution, lineage switch or development of a secondary or treatment-related malignancy, the phenotype and manifestation of subsequent leukemia may be elusive. We report on two patients with multiply relapsed/refractory B-ALL who, following chimeric antigen receptor T-cell therapy, developed myeloid malignancies. In the first case, a myeloid sarcoma developed in a patient with a history of myelodysplastic syndrome. In the second case, two distinct events occurred. The first event represented a donor-derived myelodysplastic syndrome with monosomy 7 in a patient with a prior hematopoietic stem cell transplantation. This patient went on to present with lineage switch of her original B-ALL to ambiguous lineage T/myeloid acute leukemia. With the rapidly evolving field of novel immunotherapeutic strategies, evaluation of relapse and/or subsequent neoplasms is becoming increasingly more complex. By virtue of these uniquely complex cases, we provide a framework for the evaluation of relapse or evolution of a subsequent malignancy following antigen-targeted immunotherapy.","journal":"Journal for ImmunoTherapy of Cancer","year":2020,"id":98841,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":31,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9518,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":334817,"name":"Hao‐Wei Wang","orcid":"0000-0002-5408-9253","position":1,"is_corresponding":false},{"id":487064,"name":"Aimee C. Talleur","orcid":"0000-0002-6558-6706","position":2,"is_corresponding":false},{"id":487745,"name":"Shilpa Shahani","orcid":null,"position":3,"is_corresponding":false},{"id":283310,"name":"Bonnie Yates","orcid":null,"position":4,"is_corresponding":false},{"id":280937,"name":"Haneen Shalabi","orcid":"0000-0001-8692-8034","position":5,"is_corresponding":false},{"id":487065,"name":"Michael G. Douvas","orcid":"0000-0001-7799-1920","position":6,"is_corresponding":false},{"id":218270,"name":"Katherine R. Calvo","orcid":"0000-0002-0771-4191","position":7,"is_corresponding":false},{"id":309026,"name":"Jack F. Shern","orcid":"0000-0001-5579-7625","position":8,"is_corresponding":false},{"id":487746,"name":"Sridhar Chaganti","orcid":null,"position":9,"is_corresponding":false},{"id":487747,"name":"Katharine Patrick","orcid":null,"position":10,"is_corresponding":false},{"id":92492,"name":"Young C. Song","orcid":"0000-0003-0580-1600","position":11,"is_corresponding":false},{"id":309028,"name":"Terry J. Fry","orcid":"0000-0001-8044-5226","position":12,"is_corresponding":false},{"id":255121,"name":"Xiaolin Wu","orcid":"0000-0002-6432-1300","position":13,"is_corresponding":false},{"id":415747,"name":"Brandon M. Triplett","orcid":"0000-0001-8220-9980","position":14,"is_corresponding":false},{"id":250453,"name":"Javed Khan","orcid":"0000-0002-5858-0488","position":15,"is_corresponding":false},{"id":487066,"name":"Rebecca Gardner","orcid":"0000-0003-1532-3200","position":16,"is_corresponding":false},{"id":280941,"name":"Nirali N. Shah","orcid":"0000-0002-8474-9080","position":17,"is_corresponding":false},{"id":463726,"name":"George Mo","orcid":"0009-0009-0677-3147","position":0,"is_corresponding":true}],"reference_count":20,"raw_metadata":null,"created_at":"2026-07-18T22:36:58.511143Z","pmid":"33246985","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}