Blood: Risk stratified adaptive therapy for acute lymphoblastic leukemia.
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Last Update: 2020-07-27
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Source: Internet
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Author: User
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Infants with acute lymphoblastic leukemia (ALL) !----, especially those carrying the KMT2A gene rearrangement (KMT2A-r), have a poor prognosisJapan has been working hard to study the role of stem cell transplants (HSCT) in ALL babies with KMT2A-r, but the prognosis is less effectivein the Japanese Pediatric Leukemia/Lymphoma Research Group trial MLL-10, all all infants were divided into three risk groups based on KMT2A status, age and presence of central nervous system leukemia: low risk (LR), medium risk (IR), and high risk (HR)given the improved childhood oncology AALL0631 chemotherapy program for KMT2A-r, and added a large dose of alygintos to early intensive treatment, with HSCT limited to HR patientsalso assessed the role of micro-residual lesionsrecruited a total of 90 eligible infants, the LR group has 15, the IR group has 19, the HR group has 56three-year event-free survival (EFS) in KMT2A-r ALL (IR-HR) patients and 93.3 percent in KMT2A-g ALL (LR) patientsthe three-year EFS rates were 94.4% and 56.6% forIR patients and HR patients, respectivelyin multivariate analysis, both in women and at the end of early consolidation therapy, MRD.01% were significantly undesirable factors in the prognosis, the introduction of risk stratification and intensive chemotherapy in this study is effective in replacing hSCT in some KMT2A-r ALL infantsearly removal of MRD improves prognosis, in addition, risk stratification should be included in future trials.
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