Early T-cell precursor leukemia: questions of diagnosis, treatment and description of own clinical case
https://doi.org/10.21682/2311-1267-2022-9-4-107-113
Abstract
Early T-cell precursor leukemia (early T-cell precursor, ETP-ALL) is a new subvariant of acute lymphoblastic leukemia (ALL). Tumor blasts have a unique phenotype, including signs of both stem and myeloid cells. This fact significantly complicates differential diagnosis. Cytogenetic and molecular biological features of cells in ETP-ALL are the most important diagnostic criteria. Nowadays the leading scientific international groups of pediatric leukemia conduct researches to develop new treatment protocols for ETP-ALL or to optimize existing chemotherapy regimens by including targeted drugs (bortezomib, ruxolitinib, venetoclax). Currently, hematopoietic stem cell transplantation is a mandatory option in the treatment of ETP-ALL. Targeted drugs and CAR-T-cell (chimeric antigen receptor of T-cells) therapy are the most perspective ways of posable treatment. In this article there are summarized data on diagnosis and therapy and a description of a successful treatment of a patient with ETP-ALL.
Keywords
acute lymphoblastic leukemia,
early T-cell precursor leukemia,
children,
diagnosis,
treatment,
clinical case
Supporting agencies: The study was performed without external funding
About the Authors
Yu. S. Korkina
N. N. Blokhin National Medical Research Centre of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
Pediatric Oncologist
Research Institute of Pediatric Oncology and Hematology
Department of Pediatric Oncology and Hematology (Chemotherapy of Hemoblastosis) No. 1
115478
23 Kashirskoe Shosse
Moscow
T. T. Valiev
N. N. Blokhin National Medical Research Centre of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
Dr. of Sci. (Med.), Head of the Department
Research Institute of Pediatric Oncology and Hematology
Pediatric Oncology and Hematology (Chemotherapy of Hemoblastosis) No. 1
115478
23 Kashirskoe Shosse
Moscow
K. I. Kirgizov
N. N. Blokhin National Medical Research Centre of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
Cand. of Sci. (Med.), Deputy Director for Scientific and Educational Work
Research Institute of Pediatric Oncology and Hematology
115478
23 Kashirskoe Shosse
Moscow
S. R. Varfolomeeva
N. N. Blokhin National Medical Research Centre of Oncology, Ministry of Health of Russia
Russian Federation
Russian Federation
Dr. of Sci. (Med.), Professor, Director
Research Institute of Pediatric Oncology and Hematology
115478
23 Kashirskoe Shosse
Moscow
References
1. Castaneda Puglianini O., Papadantonakis N. Early precursor T-cell acute lymphoblastic leukemia: current paradigms and evolving concepts. Ther Adv Hematol. 2020; 11: 2040620720929475. doi:10.1177/2040620720929475.
2. Fediukova Yu. G., Boichenko E. G., Popov A. M., Karachunkiy A. I. Acute lymphoblastic leukemia from early T-cell precursors: diagnosis and clinical outcomes. Yevraziyskiy Soyuz Uchenykh = Eurasian Union of Scientists. 2018; 7 (52): 56–60. (In Russ.)
3. Wang C., Oshima M., Sato D., Matsui H., Kubota S., Aoyama K., Nakajima-Takagi Y., Koide S., Matsubayashi J., Mochizuki-Kashio M., Nakano-Yokomizo T., Bai J., Nagao T., Kanai A., Iwama A., Sashida G. EZH2 loss propagates hypermethylation at T cell differentiation-regulating genes to promote leukemic transformation. J Clin Invest. 2018; 128 (9): 3872–86. doi: 10.1172/JCI94645.
4. Booth C. A. G., Barkas N., Neo W. H., Boukarabila H., Soilleux E. J., Giotopoulos G., Farnoud N., Giustacchini A., Ashley N., Carrelha J., Jamieson L., Atkinson D., Bouriez-Jones T., Prinjha R. K., Milne T. A., Teachey D. T., Papaemmanuil E., Huntly B., Jacobsen S., Mead A. J. EZH2 and RUNX1 Mutations Collaborate to Initiate Lympho-Myeloid Leukemia in Early Thymic Progenitors. Cancer Cell. 2018; 33 (2): 274–91.e8. doi: 10.1016/j.ccell.2018.01.006.
5. Bernt K. M., Hunger S. P., Neff T. The functional role of PRC2 in Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) – mechanisms and opportunities. Front Pediatr. 2016; 4 (49): 1–7. doi: 10.3389/fped.2016.00049.
6. Zhang J., Ding L., Holmfeldt L., Wu G., Heatley S. L., Payne-Turner D., Easton J., Chen X., Wang J., Rusch M., Lu C., Chen S. C., Wei L., Collins-Underwood J. R., Ma J., Roberts K. G., Pounds S. B., Ulyanov A., Becksfort J., Gupta P., Mullighan C. G. The genetic basis of early T-cell precursor acute lymphoblastic leukaemia. Nature. 2012; 481 (7380): 157–63. doi: 10.1038/nature10725.
7. Sharlai A. S., Illarionova O. I., Fediukova Y. G., Verzhbitskaya T. Yu., Fechina L. G., Boichenko E. G., Karachunskiy A. I., Popov A. M. Immunophenotypic characteristics of early T-cell precursor acute lymphoblastic leukemia. Voprosy gematologii/onkologii i immunopatologii v pediatrii = Pediatric Hematology / Oncology and Immunopathology. 2019; 18 (2): 66–74. (In Russ.)
8. Sin C. F., Man P. M. Early T-Cell Precursor Acute Lymphoblastic Leukemia: Diagnosis, Updates in Molecular Pathogenesis, Management, and Novel Therapies. Front Oncol. 2021; 11: 750789. doi: 10.3389/fonc.2021.750789.
9. Wang X. X., Wu D., Zhang L. Clinical and molecular characterization of early T-cell precursor acute lymphoblastic leukemia: Two cases report and literature review. Medicine (Baltimore). 2018; 97 (52): e13856. doi: 10.1097/MD.0000000000013856.
10. Jain N., Lamb A. V., O’Brien S., Ravandi F., Konopleva M., Jabbour E., Zuo Z., Jorgensen J., Lin P., Pierce S., Thomas D., Rytting M., Borthakur G., Kadia T., Cortes J., Kantarjian H. M., Khoury J. D. Early T-cell precursor acute lymphoblastic leukemia / lymphoma (ETP-ALL/LBL) in adolescents and adults: a high-risk subtype. Blood. 2016; 127 (15): 1863–9. doi: 10.1182/blood-2015-08-661702.
11. Conter V., Valsecchi M. G., Parasole R., Putti M. C., Locatelli F., Barisone E., Lo Nigro L., Santoro N., Aricò M., Ziino O., Pession A., Testi A. M., Micalizzi C., Casale F., Zecca M., Casazza G., Tamaro P., La Barba G., Notarangelo L. D., Silvestri D., Basso G. Childhood high-risk acute lymphoblastic leukemia in first remission: results after chemotherapy or transplant from the AIEOP ALL 2000 study. Blood. 2014; 123 (10): 1470–8. doi: 10.1182/blood-2013-10-532598.
12. Pui C. H., Sandlund J. T., Pei D., Campana D., Rivera G. K., Ribeiro R. C., Rubnitz J. E., Razzouk B. I., Howard S. C., Hudson M. M., Cheng C., Kun L. E., Raimondi S. C., Behm F. G., Downing J. R., Relling M. V., Evans W. E.; Total Therapy Study XIIIB at St. Jude Children’s Research Hospital. Improved outcome for children with acute lymphoblastic leukemia: results of Total Therapy Study XIIIB at St. Jude Children’s Research Hospital. Blood 2004; 104 (9): 2690–6. doi: 10.1182/blood-2004-04-1616.
13. Manabe A., Ohara A., Hasegawa D., Koh K., Saito T., Kiyokawa N., Kikuchi A., Takahashi H., Ikuta K., Hayashi Y., Hanada R., Tsuchida M.; Tokyo Children’s Cancer Study Group. Significance of the complete clearance of peripheral blasts after 7 days of prednisolone treatment in children with acute lymphoblastic leukemia: the Tokyo Children’s Cancer Study Group Study L99-15. Haematologica. 2008; 93 (8): 1155–60. doi: 10.3324/haematol.12365.
14. Vora А., Goulden N., Mitchell C., Hancock J., Hough R., Rowntree C., Moorman A. V., Wade R. Augmented post-remission therapy for a minimal residual disease-defi ned high-risk subgroup of children and young people with clinical standard-risk and intermediate-risk acute lymphoblastic leukaemia (UKALL 2003): a randomised controlled trial. Lancet Oncol. 2014; 15 (8): 809–18. doi: 10.1016/S1470-2045(14)70243-8.
15. Kolbin A. S., Gomon Yu. M., Balykina Yu. E., Proskurin M. A. Pharmacoeconomic Analysis of Gilteritinib in the Therapy of Adult Patients with Relapsed / Refractory Acute Myeloid Leukemias with FLT3 Mutation. Klinicheskaya oncogematologia = Clinical Oncohematology. 2022; 15 (1): 85–96. (In Russ.)
16. Gutierrez A., Dahlberg S. E., Neuberg D. S., Zhang J., Grebliunaite R., Sanda T., Protopopov A., Tosello V., Kutok J., Larson R. S., Borowitz M. J., Loh M. L., Ferrando A. A., Winter S. S., Mullighan C. G., Silverman L. B., Chin L., Hunger S. P., Sallan S. E., Look A. T. Absence of biallelic TCRgamma deletion predicts early treatment failure in pediatric T-cell acute lymphoblastic leukemia. J Clin Oncol. 2010; 28 (24): 3816–23. doi: 10.1200/JCO.2010.28.3390.
17. McEwan A., Pitiyarachchi O., Viiala N. Relapsed/Refractory ETP-ALL Successfully Treated With Venetoclax and Nelarabine as a Bridge to Allogeneic Stem Cell Transplant. Hemasphere. 2020; 4 (3): e379. doi: 10.1097/HS9.0000000000000379.
18. Lato M. W., Przysucha A., Grosman S., Zawitkowska J., Lejman M. The New Therapeutic Strategies in Pediatric T-Cell Acute Lymphoblastic Leukemia. Int J Mol Sci. 2021; 22 (9): 4502. doi: 10.3390/ijms22094502.
19. Dai H. P., Cui W., Cui Q. Y., Zhu W. J., Meng H. M., Zhu M. Q., Zhu X. M., Yang L., Wu D. P., Tang X. W. Haploidentical CD7 CAR T-cells induced remission in a patient with TP53 mutated relapsed and refractory early T-cell precursor lymphoblastic leukemia / lymphoma. Biomark Res. 2022; 10 (1): 6. doi: 10.1186/s40364-022-00352-w.
20. Punatar S., Gokarn A., Nayak L., Bonda A., Chichra A., Mirgh S., Bagal B., Tembhare P., Subramanian P., Khattry N. Long term outcome of a patient with relapsed refractory early thymic precursor acute lymphoblastic leukemia treated with daratumumab. Am J Blood Res. 2021; 11 (5): 528–33. PMID: 34824885.
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For citations:
Korkina Yu.S., Valiev T.T., Kirgizov K.I., Varfolomeeva S.R. Early T-cell precursor leukemia: questions of diagnosis, treatment and description of own clinical case. Russian Journal of Pediatric Hematology and Oncology. 2022;9(4):107-113. (In Russ.) https://doi.org/10.21682/2311-1267-2022-9-4-107-113
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