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ASH 2015: Real-Time Classification System Identifies Leukemia Patients With High-Risk Clinical Features but Outstanding Outcomes

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Key Points

  • Investigators determined that the 5-year event-free survival rate varies according to genetic subset, ranging from 70% for those with unfavorable cytogenetics to 95% for those with favorable cytogenetic abnormalities.
  • Patients with either standard or high-risk disease and favorable cytogenetic findings, who accounted for almost half of all patients, had a 98% likelihood of being alive 5 years following diagnosis. 

A study to be reported by Raetz et al at the 57th American Society of Hematology (ASH) Annual Meeting examined the potential of using real-time genetic analysis to personalize chemotherapy regimens for children with B-cell lymphocytic leukemia (Abstract 807). The study findings were presented at a press conference held during the ASH meeting.

Adjusting the intensity of treatment based on the patient’s likelihood of relapse has emerged as a promising strategy for treating children with acute lymphocytic leukemia.

This study is the first Children’s Oncology Group (COG) study to systematically assess minimal residual disease at the end of induction therapy and to use this, in concert with clinical and biologic data, for risk stratification and treatment assignment. 

Newly diagnosed B-cell lymphocytic leukemia patients between 1 and 30 years of age received either standard or high-risk initial chemotherapy regimens based on the National Cancer Institute (NCI) definitions of these risks.

Study Details

Patients underwent standardized testing to detect cytogenetic abnormalities associated with favorable and unfavorable outcomes. The investigators classified 5,104 NCI standard-risk and 2,791 NCI high-risk patients into low, standard, high, or very high risk groups at the end of induction therapy based on the presence of favorable and unfavorable cytogenetic findings and early treatment response. 

The researchers determined that the 5-year event-free survival rate varies according to genetic subset, ranging from 70% for those with unfavorable cytogenetics to 95% for those with favorable cytogenetic abnormalities. Notably, patients with either standard-risk or high-risk disease and favorable cytogenetic findings, who accounted for almost half of all patients, had a 98% likelihood of being alive 5 years after diagnosis. 

According to the investigators, the results demonstrated that this real-time classification identified a previously unrecognized subset of high-risk patients with excellent chances for cure, without further intensification of treatment.  

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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