Blood: Risk stratization therapy for infants with acute lymphoblastic leukemia.

In clinical practice, children with acute lymphoblastic leukemia (ALL), especially those with KMT2A gene rearfraging (KMT2A-R), had poor prognosis, especially hematopoietic stem cell transplantation (HSCT) with little effect on KMT2A-R infants and young children.
recently, in the Japanese Pediatric Leukemia/Lymphoma Research Group MRL-10 trial, all infants were divided into three groups: Low Risk (LR), Intermediate Risk (IR) and High Risk (HR) based on KMT2A status, age, and central nervous system leukemia.
high doses of agarose cytosine in early intensive chemotherapy and HSCT was only performed on children with HR, while micro-disease residues (MRD) were assessed.
end of the study was a three-year event-free survival rate.
90 children were involved in the study, including 15 in the LR group, 19 in the IR group and 56 in the HR group.
in children with KMT2A-R in IR and HR, the three-year event-free survival rate (EFS) was 66.2%, and for children with KMT2A-R in LR, the three-year EFS was 93.32%.
94.4% of all IRS patients overall, compared with 56.6% of children with HR.
multi-factor analysis showed that 0.01% of MRD ≥ and early consolidation therapy were associated with poor prognosmation.
studies have shown that risk stratification and early intensive chemotherapy can reduce low-risk KMT2A gene re-discharge in children for hematopoietic stem cell transplantation, and that the early clearance rate of micro-disease residues is also beneficial for patient prognosis.
.