Skoltech scientist Marat Kazanov has co-authored a paper “Lineage Conversion in Pediatric B-Cell Precursor Acute Leukemia under Blinatumomab Therapy” that has been recently published in International Journal of Molecular Sciences. The authors of the article documented six cases of lineage switch that occurred after or during blinatumomab exposure. Therefore, lineage conversion was found in 17.4% of all resistance cases (4/27) and 3.2% of relapses (2/63). The researchers report incidence and deep molecular characteristics of lineage switch in 182 pediatric patients affected by B-cell precursor acute lymphoblastic leukemia (BCP-ALL), who were treated with blinatumomab. We documented six cases of lineage switch that occurred after or during blinatumomab exposure. The studied cases showed consistency of gene rearrangements and fusion transcripts across initially diagnosed leukemia and lineage switch. The scientists conclude that the immunophenotype of an existing leukemia sometimes changes via different mechanisms and with different additional molecular changes. Careful investigation of all BM compartments together with all molecular –minimal residual disease studies can lead to reliable identification of lineage switch. Full text of the paper is available here.