Dynamic lineage evolution in hematologic malignancies: a case report of B-ALL Progressing to CMML and AML
Sheikh Abdullah, Mariana Marrero Castillo, Shiva Jashwanth Gaddam, Benedict Amalraj, Faryal Shoaib, Poornima Ramadas · 2026
Read Dynamic lineage evolution in hematologic malignancies: a case report of B-ALL Progressing to CMML and AML by Sheikh Abdullah, Mariana Marrero Castillo, Shiva Jashwanth Gaddam, Benedict Amalraj, Faryal Shoaib, Poornima Ramadas (2026) in the Tower of Babel, a free online library of public-domain works preserved in clean, searchable text. No sign-up. The full text is served as a plain-text file at a predictable URL, where text is present: https://antarctic-labs.com/tower-of-babel/PMC13500408.txt.
Description
Sheikh Abdullah and co-authors write to the editor in 2026 about a blood cancer that changed identity twice in one patient. Lineage switching, where a lymphoid leukaemia returns as a myeloid disease, is a recognised escape route after immune therapy. A stepwise path through a defined intermediate cancer is rarely documented in adults. Their patient was a 69-year-old woman whose B-cell acute lymphoblastic leukaemia passed through chronic myelomonocytic leukaemia before becoming acute monoblastic leukaemia.
Serial molecular profiling across her treatment course from April 2024 to August 2025 tracked how mutation levels shifted with each phase. One RAS-family mutation persisted at low level during remission, surged as the intermediate disease emerged, and fell with treatment, while new mutations appeared at the final transition. The pattern favoured a two-lineage RAS-driven process over a simple single-clone switch, a distinction the authors argue matters for monitoring similar patients.
Catalog record
| CREATOR | Sheikh Abdullah, Mariana Marrero Castillo, Shiva Jashwanth Gaddam, Benedict Amalraj, Faryal Shoaib, Poornima Ramadas |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 15577 |
| LICENSE | https://creativecommons.org/licenses/by/4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |