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MRD, Genetic Classification Provide More Accurate Risk Stratification in Pediatric ALL

Jason Harris
Published: Friday, Nov 17, 2017

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Investigators working in the UK and Europe found a correlation between minimal residual disease (MRD) kinetics and risk for relapse in pediatric patients with acute lymphoblastic leukemia (ALL).1

“Overall, this is an important study that provides new insights into the complex interplay between clinical risk factors, tumor genomics, and MRD that is linked to [risk for relapse] and outcome,” Hunger wrote. “These results challenge cooperative groups to use MRD in a more sophisticated way than the typically dichotomous definition of good or poor responders on the basis of one single threshold for all patients. To develop true precision medicine strategies for pediatric patients with ALL, we must accept this challenge and use integrated models in clinical trial design.”

References

  1. O’Connor D, Enshaei A, Bartram J, et al. Genotype-specific minimal residual disease interpretation improves stratification in pediatric acute lymphoblastic leukemia. J Clin Oncol [published online November 13, 2017]. doi: 0.1200/JCO.2017.74.0449.
  2. Vora A, Goulden N, Wade R. Treatment reduction for children and young adults with low-risk acute lymphoblastic leukaemia defined by minimal residual disease (UKALL 2003): a randomised controlled trial. Lancet Oncol. 2013;14(3):199-209. doi: 10.1016/S1470-2045(12)70600-9.
  3. Hunger SP. Integrated risk stratification using minimal residual disease and sentinel genetic alterations in pediatric acute lymphoblastic leukemia. J Clin Oncol [published online November 13, 2017]. doi: 10.1200/JCO.2017.76.0504.

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