{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:12:08Z","timestamp":1788444728593,"version":"build-2803163510"},"reference-count":60,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    CD19\u2010directed therapy remains the mainstay treatment for relapsed\/refractory B\u2010cell acute lymphoblastic leukemia (ALL). However, treatment patterns and outcomes following CD19\u2010negative (CD19\u2010) relapse remain poorly defined. We retrospectively analyzed 65 adult patients with ALL who developed CD19\u2010relapse after CD19\u2010directed therapy. TP53 mutations and\n                    <jats:italic>BCR::ABL1<\/jats:italic>\n                    \u2010like ALL were each identified in 27.7% (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200918) of patients. Forty\u2010six patients (70.8%) received one CD19\u2010targeted therapy, whereas 19 patients (29.2%) received \u2265\u20092 prior to CD19\u2010relapse. Overall, 60 patients (92.3%) received blinatumomab, and 23 (35.4%) received CAR T\u2010cell therapy. The median time from the initiation of the most recent CD19\u2010targeted therapy to CD19\u2010relapse was 155\u2009days (range, 13\u20131946). The median follow\u2010up of the entire cohort was 32.7\u2009months (IQR, 15.1\u201390.3). The median event\u2010free and overall survival (EFS and OS) was 3.1\u2009months (95% CI, 2.5\u20134.5) and 9.9\u2009months (95% CI, 6.8\u201324.7), respectively. In multivariate analysis, receipt of \u2265\u20092 CD19\u2010directed therapies was associated with both inferior EFS and OS, HR 2.17 (95% CI, 1.10\u20134.29;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.03) and HR 3.05 (95% CI, 1.40\u20136.62;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005). The complete remission rate following first salvage therapy was 47.5% and 72.1% any time following CD19\u2010relapse. Sixteen (34.8%) of 46 patients evaluated had subsequent CD19 re\u2010expression, 5 of whom subsequently received CD19\u2010directed therapy, and all 5 patients responded. Patients with ALL who develop CD19\u2010relapse after CD19\u2010directed therapy have poor outcomes and limited therapeutic options. However, since this study lacked a comparator cohort of patients with CD19\u2010positive relapse, the independent prognostic impact of CD19 negativity could not be determined.\n                  <\/jats:p>","DOI":"10.1002\/ajh.70450","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T01:42:54Z","timestamp":1784857374000},"page":"2533-2545","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Implications of\n                    <scp>CD19<\/scp>\n                    \u2010Negative Relapse Following\n                    <scp>CD19<\/scp>\n                    \u2010Directed Therapy in B\u2010Cell Acute Lymphoblastic Leukemia"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6376-4495","authenticated-orcid":false,"given":"Tamer","family":"Othman","sequence":"first","affiliation":[{"name":"Hematology and Hematopoietic Cell Transplantation, City 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