Among patients with B-lineage acute lymphoblastic leukemia (ALL), the VpreB1 subunit of the immunoglobulin heavy chain surrogate light chain (SLC) may represent a novel therapeutic target, according to research published in Blood Advances.

The pre-B cell receptor (BCR), which is involved in immature B cell selection and expansion, consists of 5 units, of which 1 is the SLC. Impaired pre-BCR activity may, furthermore, lead to the development and proliferation of B cell cancers, including ALL. 

While existing targeted therapies have improved outcomes among patients with ALL, relapse is common, representing a need for novel therapies for this patient population. Previous research has suggested that incubating patient blasts with monoclonal antibodies targeting VpreB—CD179a—may induce apoptosis.

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For this study, researchers evaluated whether CD179a may be highly expressed on B lymphoblasts, and consequently represent a promising therapeutic target among patients with B-lineage ALL.

Overall, 36 patient samples from individuals accrued to a Children’s Oncology Group study were evaluated using a minimal residual disease (MRD) flow panel to evaluate pre-BCR expression. CD179a expression was also evaluated in 16 samples at end-induction; these samples had at least 1% MRD.

The majority (32) of cases were at the pre-B stage of developmental arrest, while 4 cases were at the pro-B stage. Analysis suggested that CD179a was present in at least 20% of B lymphoblasts. At end-induction, CD179a was expressed in all B lymphoblasts.

CD179a was, according to the authors, expressed in B-lineage ALL regardless of genotype or disease risk status. The authors proposed to “assess in future clinical trials whether immunotherapies against the pre-BCR might spare a patient’s mature B-cell repertoire.”


Winter SS, McCaustland A, Qu C, et al. VpreB surrogate light chain expression in B-lineage ALL: a report from the Children’s Oncology Group. Blood Adv. 2022;6(2):585-589. doi:10.1182/bloodadvances.2021005245