Myeloid leukemia switch as immune escape from CD19 chimeric antigen receptor (CAR) therapy

Gardner et al. recently reported on two cases of mixed lineage leukemia (MLL)⁺ acute myeloid leukemia (AML) occurring after CD19 chimeric antigen receptor (CAR) therapy for MLL⁺ B-acute lymphoblastic leukemia (ALL) (1). This report provides new insights into mechanisms of immune escape from targeted immunotherapy and strategies to prevent their occurrence with adapted immune interventions.