Remission, treatment failure, and relapse in pediatric ALL: an international consensus of the Ponte-di-Legno Consortium
Publikation: Bidrag til tidsskrift › Kommentar/debat › Forskning › fagfællebedømt
Comparison of treatment strategies in de novo pediatric acute lymphoblastic leukemia (ALL) requires standardized measures of efficacy. Key parameters that define disease-related events, including complete remission (CR), treatment failure (TF; not achieving CR), and relapse (loss of CR) require an updated consensus incorporating modern diagnostics. We collected the definitions of CR, TF, and relapse from recent and current pediatric clinical trials for the treatment of ALL, including the key components of response evaluation (timing, anatomic sites, detection methods, and thresholds) and found significant heterogeneity, most notably in the definition of TF. Representatives of the major international ALL clinical trial groups convened to establish consensus definitions. CR should be defined at a time point no earlier than at the end of induction and should include the reduction of blasts below a specific threshold in bone marrow and extramedullary sites, incorporating minimal residual disease (MRD) techniques for marrow evaluations. TF should be defined as failure to achieve CR by a prespecified time point in therapy. Relapse can only be defined in patients who have achieved CR and must include a specific threshold of leukemic cells in the bone marrow confirmed by MRD, the detection of central nervous system leukemia, or documentation of extramedullary disease. Definitions of TF and relapse should harmonize with eligibility criteria for clinical trials in relapsed/refractory ALL. These consensus definitions will enhance the ability to compare outcomes across pediatric ALL trials and facilitate development of future international collaborative trials.
Originalsprog | Engelsk |
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Tidsskrift | Blood |
Vol/bind | 139 |
Udgave nummer | 12 |
Sider (fra-til) | 1785-1793 |
Antal sider | 9 |
ISSN | 0006-4971 |
DOI |
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Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
This project was supported by Deutsche Krebshilfe grants 108588, 70112517, and 70112958, the Italian Association for Cancer Research (AIRC IG 2017: 20564, AIRC IG 2018: 21724 and IG2015:17593, CRUK/AIRC/FC AECC 22791, AIRC Molecular Clinical Oncology 5 per mille 21147), the French Hospital Program for Clinical Research (PHRC 10-02-05), the Danish Childhood Cancer Foundation (2019-5934), the Danish Cancer Society (R257-A14720), US National Cancer Institute (CA021765), American Lebanese Syrian Associated Charities, the Swedish Childhood Cancer Fund (TJ2017-0076), Japan Agency for Medical Research and Development (AMED) (21ck0106612h0002), Blood Cancer UK, NCTN Operations Center and Statistics & Data Center (SDC) grants (U10CA180886 and U10CA180899, respectively) and the St Baldrick’s Foundation (COG).
Publisher Copyright:
© 2022 American Society of Hematology
ID: 310423082