MRD-based tailored therapy in childhood ALL
Professor Rob Pieters (Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands) discussed in the Laboratory Hematology Workshop how therapy can be tailored based on MRD-based risk groups in children with acute lymphoblastic leukemia (ALL). In the DCOG ALL-10 study therapy was significantly reduced in the low-risk group, and intensified in the intermediate and high-risk groups.1 In the low-risk group therapy reduction did not affect survival, although the incidence of relapses slightly increased.
In a new study of the ALLTogether Consortium a combination of MRD and high-risk genetics will be used to stratify patients. The intermediate-risk (IR) group will be split up into IR-low and IR-high, with a low and high risk of relapses, respectively. The IR-low group will again receive reduced therapy, whereas therapy will be intensified in the IR-high group.
- Pieters R, et al. J Clin Oncol. 2016 Aug 1;34(22):2591-601.