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Clonal origin of lineage switch leukemia following CAR-T cell and blinatumomab therapy

Children with ALL treated with anti-CD19 therapy occasionally develop a phenotypically distinct AML. However, the precise clonal origin of such class switch leukemias remains unresolved. Here, we reconstructed the evolution of leukemia in a child with primary ALL, two ALL relapses and AML after treatment with anti-CD19 CAR-T and blinatumomab through whole-genome sequencing. The phylogeny revealed that the AML was a monoclonal outgrowth descending from the initial ALL and harbored biallelic loss of CDKN2A, PAX5 and TP53. However, none of the ALL or AML relapses directly descended from one another, suggesting the presence of a reservoir of persistent clones. Our findings suggest anti-CD19 treatment selects pre-existing clones, with many key genetic alterations underpinning the lineage switch detectable prior to treatment.

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Studies are experimental investigations of a particular phenomenon, e.g., case-control studies on a particular trait or cancer research projects reporting matching cancer normal genomes from patients.

Study ID Study Title Study Type
Whole Genome Sequencing

This table displays only public information pertaining to the files in the dataset. If you wish to access this dataset, please submit a request. If you already have access to these data files, please consult the download documentation.

ID File Type Size Located in
EGAF00006702130 1659616221019 70.5 GB
EGAF00006702131 1659615321019 67.2 GB
EGAF00006702132 1659615321019 73.8 GB
EGAF00006702133 1659616221019 67.3 GB
EGAF00006702134 1659614421023 61.2 GB
EGAF00006702135 1659616221019 79.5 GB
EGAF00006702136 1659615321019 60.4 GB
EGAF00006702137 1659615321019 71.5 GB
8 Files (551.5 GB)