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Updated: Dec 29, 2025
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Dynamic Imaging of Chimeric Antigen Receptor T Cells with [18F]Tetrafluoroborate Positron Emission Tomography/Computed Tomography
Published on: February 17, 2022
CD22 Expression in B-Cell Acute Lymphoblastic Leukemia: Biological Significance and Implications for Inotuzumab
Francesco Lanza1, Enrico Maffini1, Michela Rondoni1
1Hematology Unit & Romagna Transplant Network, Ravenna Hospital, 48121 Ravenna, Italy.
Insights
CD22 antibodies show promise in treating B-cell acute lymphoblastic leukemia (B-ALL). Analyzing CD22 expression may predict treatment response, potentially improving outcomes for refractory B-ALL patients.
Area of Science:
- Immunology
- Hematology
- Oncology
Background:
- CD22 is a B-cell surface molecule present in most B-cell acute lymphoblastic leukemia (B-ALL) blasts.
- Current B-ALL therapies have limited long-term efficacy, with high relapse rates.
- Refractory/relapsed B-ALL shows poor response to conventional chemotherapy.
Purpose of the Study:
- To review the biological and clinical activities of CD22 antibodies in B-ALL.
- To explore the role of CD22 expression analysis in predicting treatment response.
- To highlight novel immune-targeted therapies for B-ALL.
Main Methods:
- Review of existing literature on CD22 antibodies and B-ALL.
- Analysis of clinical data regarding CD22 expression and treatment outcomes.
- Discussion of novel therapeutic strategies including antibody-drug conjugates.
Main Results:
- Inotuzumab ozogamicin, an anti-CD22 antibody, achieved complete remission in 80% of B-ALL patients.
- CD22 antibodies offer a mechanism to bypass chemo-refractory leukemia cells.
- Qualitative and quantitative CD22 analysis may predict leukemic cell depletion.
Conclusions:
- CD22 antibodies represent a promising therapeutic avenue for B-ALL.
- CD22 expression analysis could personalize treatment strategies for B-ALL.
- Targeting CD22 offers a novel approach to improve clinical response rates in B-ALL.
Abstract:
CD22 is a surface molecule expressed early during the ontogeny of B cells in the bone marrow and spleen, and can be found on B cells isolated from the different lymphoid compartments in humans. CD22 is expressed by most blasts from the majority (60-90%) of B-cell acute lymphoblastic leukemia (B-ALL). Current therapies in adults with newly diagnosed B-ALL are associated with complete remission (CR) rates of 50-90%. However, 30-60% of these patients relapse, and only 25-40% achieve disease-free survival of three years or more. Chemotherapy regimens for patients with refractory/relapsed B-ALL are associated with CR rates ranging from 31% to 44%. Novel immune-targeted therapies, such as blinatumomab and inotuzumab (a humanized anti-CD22 monoclonal antibody conjugated to the cytotoxic antibiotic agent calicheamicin), provide potential means of circumventing chemo-refractory B-ALL cells through novel mechanisms of action. Eighty percent of inotuzumab-treated B-ALL patients may achieve a CR state. This review is focused on the biological and clinical activities of CD22 antibodies in B-ALL, and provides evidence about the potential role played by qualitative and quantitative analysis of the CD22 molecule on individual B-ALL blasts in predicting the depletion of leukemic cells, and, ultimately, leading to better clinical response rates.
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