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Expression of Exogenous Cytokine in Patient-derived Xenografts via Injection with a Cytokine-transduced Stromal Cell Line

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Pediatric T-Lymphoblastic Leukemia With Aberrant B-Cell Marker Expression: A Potential Role for Targeted Therapy.

Mahsa Khanlari¹, Wei Wang², Paul E Mead¹

¹Department of Pathology St. Jude Children's Research Hospital Memphis Tennessee USA.

|November 28, 2025

Summary

This pediatric T-lymphoblastic leukemia/lymphoma case with B-cell antigen expression and a SET::NUP214 fusion highlights the need for integrated flow cytometry and sequencing. Combined therapies achieved remission after initial treatment failure.

Keywords:

NUP214 T‐LBLL blinatumomab targeted therapy

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Area of Science:

Hematology
Oncology
Genetics

Background:

B-cell antigen expression is uncommon in T-lymphoblastic leukemia/lymphoma (T-LBLL).
The clinical significance of co-expressing B-cell antigens in T-LBLL remains unclear.

Purpose of the Study:

To present a pediatric case of acute leukemia with mixed T-cell and B-cell (CD19) marker expression.
To investigate the genetic underpinnings of this rare leukemia subtype using next-generation sequencing (NGS).
To evaluate treatment strategies for this challenging diagnosis.

Main Methods:

Diagnosis was established using multicolor flow cytometry (MFC) for immunophenotyping.
Next-generation sequencing (NGS) identified a SET::NUP214 gene fusion.
Treatment involved conventional acute lymphoblastic leukemia (ALL) therapy, blinatumomab, decitabine, venetoclax, and bone marrow stem cell transplant (BMSCT).

Main Results:

The patient's leukemia expressed T-cell markers and CD19.
Conventional ALL therapy resulted in significant residual disease.
Subsequent treatment with blinatumomab, decitabine, and venetoclax led to morphologic remission, followed by molecular remission post-BMSCT.

Conclusions:

Integrated analysis of MFC and NGS data is crucial for personalized treatment of T-LBLL.
This case demonstrates a potential therapeutic pathway for T-LBLL with B-cell antigen expression and SET::NUP214 fusion.