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Open AccessReview

CD22 Expression in B-Cell Acute Lymphoblastic Leukemia: Biological Significance and Implications for Inotuzumab Therapy in Adults

1
Hematology Unit & Romagna Transplant Network, Ravenna Hospital, 48121 Ravenna, Italy
2
Clinical Pathology Unit, Hub Laboratory, Romagna Transplant Network, 47522 Cesena (FC), Italy
3
Department of Medical Science, University of Torino and Fondazione Ricerca Molinette, 10126 Torino, Italy
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(2), 303; https://doi.org/10.3390/cancers12020303
Received: 23 December 2019 / Revised: 22 January 2020 / Accepted: 24 January 2020 / Published: 28 January 2020
(This article belongs to the Special Issue Recent Advances in the Pathogenesis of B Cell Malignancies)
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. View Full-Text
Keywords: B-ALL; CD22; inotuzumab; antigen modulation B-ALL; CD22; inotuzumab; antigen modulation
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Lanza, F.; Maffini, E.; Rondoni, M.; Massari, E.; Faini, A.C.; Malavasi, F. CD22 Expression in B-Cell Acute Lymphoblastic Leukemia: Biological Significance and Implications for Inotuzumab Therapy in Adults. Cancers 2020, 12, 303.

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