{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:00:42Z","timestamp":1790589642451,"version":"4.1.0"},"reference-count":14,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370171"],"award-info":[{"award-number":["82370171"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin &amp; Trans Imm"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Long\u2010term disease control in transplant\u2010ineligible patients with high\u2010risk Philadelphia chromosome\u2010positive acute lymphoblastic leukaemia (Ph\n                      <jats:sup>+<\/jats:sup>\n                      \u2009ALL) remains difficult, particularly when adverse genetic lesions and acquired kinase domain mutations coexist.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Clinical, cytogenetic and molecular records were retrospectively reviewed.\n                      <jats:italic>BCR::ABL1<\/jats:italic>\n                      transcripts were monitored by quantitative PCR, and peripheral lymphocyte subsets were followed longitudinally. Public transcriptomic data (GSE196463) were analysed to compare T\u2010cell expression profiles under continuous versus intermittent bispecific antibody exposure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A 64\u2010year\u2010old man with Ph\n                      <jats:sup>+<\/jats:sup>\n                      \u2009ALL harbouring a heterozygous\n                      <jats:italic>IKZF1<\/jats:italic>\n                      deletion relapsed while receiving dasatinib, with emergence of an ABL1 E255K\/V mutation. Although this P\u2010loop mutant retains sensitivity to dasatinib, relapse suggested kinase\u2010independent escape; treatment was redirected towards immune\u2010mediated clearance with one cycle of continuous blinatumomab plus dasatinib, achieving deep molecular remission. Allogeneic transplantation was deferred because of advanced age, prior cardiac dysfunction and cumulative infectious burden, and outpatient maintenance was initiated with monthly 24\u2010h blinatumomab infusions (35\u2009\u03bcg) plus dasatinib (100\u2009mg daily) and subcutaneous interferon alfa\u20102b (3 MIU thrice weekly). Morphologic remission was sustained for over 3.5\u2009years with no unplanned hospitalizations and no grade \u22653 neurotoxicity.\n                      <jats:italic>BCR::ABL1<\/jats:italic>\n                      transcripts remained undetectable for nearly 3\u2009years before a transient low\u2010level fluctuation (0.0024% IS) appeared and stabilized without treatment escalation. Peripheral monitoring showed persistent CD8\n                      <jats:sup>+<\/jats:sup>\n                      predominance and sustained B\u2010cell depletion (&lt;20 cells\/\u03bcL), indicating ongoing target engagement. Public transcriptomic data supported that intermittent bispecific exposure preserves progenitor\/memory T\u2010cell programmes while limiting exhaustion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Intermittent reduced\u2010intensity blinatumomab maintenance guided by serial MRD monitoring was feasible and associated with durable molecular control in a transplant\u2010ineligible patient with high\u2010risk Ph\n                      <jats:sup>+<\/jats:sup>\n                      \u2009ALL. This strategy merits prospective evaluation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cti2.70121","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:25:54Z","timestamp":1790051154000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prolonged molecular control during intermittent reduced\u2010intensity blinatumomab maintenance in a transplant\u2010ineligible patient with Philadelphia chromosome\u2010positive acute lymphoblastic leukaemia and\n                    <i>IKZF1<\/i>\n                    deletion"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3491-3702","authenticated-orcid":false,"given":"Xiaoqian","family":"Duan","sequence":"first","affiliation":[{"name":"Department of Hematology and Institute of Hematology West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8998-8796","authenticated-orcid":false,"given":"Jinjun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Hematology and Institute of Hematology West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Hematology and Institute of Hematology West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuwen","family":"Guo","sequence":"additional","affiliation":[{"name":"West China School of Medicine Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8708-9711","authenticated-orcid":false,"given":"Yu","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Hematology and Institute of Hematology West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023023568"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2016272"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(22)00319-2"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.57264\/cer-2023-0142"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1609783"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-08-798322"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023023152"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022015956"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-12-326405"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-020-0776-2"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.01075"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.69.3531"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-03-707562"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.21.6408"}],"container-title":["Clinical &amp; Translational Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cti2.70121","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cti2.70121","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cti2.70121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:54:51Z","timestamp":1790589291000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cti2.70121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":14,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/cti2.70121"],"URL":"https:\/\/doi.org\/10.1002\/cti2.70121","archive":["Portico"],"relation":{},"ISSN":["2050-0068","2050-0068"],"issn-type":[{"value":"2050-0068","type":"print"},{"value":"2050-0068","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-06-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70121"}}