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Targeted CD123 therapy in ALL
Although a higher number of CD123+ leukemic stem cells was shown to have a negative impact on leukemia- free and overall survival in patients with acute myeloid leukemia,25,32 information on the prognostic impact of CD123 expression in ALL has been limited and unclear. In a large study of pediatric ALL, high-level CD123 expres- sion was most common in patients with a hyperdiploid karyotype, a favorable prognostic marker.18 We did not identify such a correlation in this study group of mostly adult patients. In T-ALL patients, CD123 expression was not found to be prognostic of outcome after first induction treatment.30 In our study group, we did not identify a cor-
relation between CD123 prevalence and leukemia-free sur- vival or overall survival in B-ALL, but we did observe a sig- nificant correlation between the intensity of CD123 expression and leukemia-free survival. We acknowledge that this finding in a limited group of patients warrants fur- ther validation in a larger cohort.
In conclusion, data from this study show that CD123 is widely expressed in B-ALL and to a lesser degree in T- ALL, and they confirm its potential utility as a therapeu- tic target. IMGN632, an antibody-drug conjugate which targets CD123, has promising preclinical activity against B-ALL.
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