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BL22 is a recombinant anti-CD22 immunotoxin fusion protein composed of a murine anti-CD22 antibody fragment (disulfide-linked Fv, dsFv) fused to a truncated form of *Pseudomonas* exotoxin A (PE38). It specifically binds to CD22-positive cells and is internalized, leading to intracellular release of the toxin. The toxin moiety induces caspase-mediated apoptosis via mitochondrial damage and blocks translational elongation by inactivating elongation factor 2. This results in cell death of malignant B-cells expressing CD22. BL22 was primarily developed for the treatment of chemotherapy-resistant hairy cell leukemia and showed activity in phase I/II trials for this indication. Development was discontinued in favor of moxetumomab pasudotox (HA22), which has improved potency and safety[1][2][3][4].
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