{"id":2123,"date":"2024-12-06T04:11:56","date_gmt":"2024-12-06T04:11:56","guid":{"rendered":"https:\/\/suburban-blog.abymtech.com\/?p=2123"},"modified":"2025-03-05T10:08:50","modified_gmt":"2025-03-05T10:08:50","slug":"pediatric-and-adult-acute-lymphoblastic-leukemia","status":"publish","type":"post","link":"https:\/\/www.suburbandiagnostics.com\/blog\/pediatric-and-adult-acute-lymphoblastic-leukemia\/","title":{"rendered":"Pediatric &#038; Adult Acute Lymphoblastic Leukemia"},"content":{"rendered":"<p><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone wp-image-2133\" src=\"https:\/\/suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia-300x180.webp\" alt=\"\" width=\"1203\" height=\"722\" title=\"\" srcset=\"https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia-300x180.webp 300w, https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia-768x461.webp 768w, https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia.webp 1000w\" sizes=\"(max-width: 1203px) 100vw, 1203px\" \/><\/p>\n<p style=\"font-weight: 400;\"><b>SUBURBAN JOURNAL CLUB<\/b><\/p>\n<p style=\"font-weight: 400;\"><b>A monthly precis of some of the best, most influential journal articles.<\/b><\/p>\n<p style=\"font-weight: 400;\"><b>Journal Article<\/b>: Association Of Minimal Residual Disease With Clinical Outcome In Pediatric &amp; Adult Acute Lymphoblastic Leukemia: A Meta-analysis<\/p>\n<p style=\"font-weight: 400;\"><b>Journal<\/b>: JAMA Oncology, Volume 3, 2017<\/p>\n<p style=\"font-weight: 400;\"><b>DOI<\/b>: 10.1001\/jamaoncol.2017.0580<\/p>\n<p style=\"font-weight: 400;\"><b>Introduction:<\/b><\/p>\n<ul style=\"font-weight: 400;\">\n<li>Minimal residual disease (MRD) refers to the presence of disease in cases deemed to be in complete remission by conventional pathologic analysis.<\/li>\n<li>Detecting MRD in various hematological malignant diseases has been <b>associated with higher relapse rates<\/b> &#8211; these include chronic myeloid leukemia (CML), acute myeloid leukemia (AML), acute and chronic lymphoblastic leukemia (ALL and CLL), and multiple myeloma.<\/li>\n<li>Minimal residual disease in patients with ALL can be measured in several ways, including by multiparametric flow cytometry (MFC), by polymerase chain reaction (PCR) of the IgH VDJ and\/or TCR gene rearrangements, and by leukemia specific fusion transcripts (eg, BCR-ABL).<\/li>\n<li>The authors identified 39 studies with 13,637 patients to assess the association of MRD with clinical outcome in ALL.<\/li>\n<\/ul>\n<p style=\"font-weight: 400;\"><b>Results:<\/b><\/p>\n<table>\n<tbody>\n<tr>\n<td style=\"background-color: #ffc000;\"><b>Clinical outcomes<\/b><\/td>\n<td style=\"background-color: #ffc000;\"><b>MRD-negative patients<\/b><\/td>\n<td style=\"background-color: #ffc000;\"><b>MRD-positive patients<\/b><\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #fff2cc;\" colspan=\"3\"><b>Pediatric Patients<\/b><\/td>\n<\/tr>\n<tr>\n<td>Disease-free after 10 years<\/td>\n<td>77%<\/td>\n<td>32%<\/td>\n<\/tr>\n<tr>\n<td>Alive after 10 years<\/td>\n<td>84%<\/td>\n<td>55%<\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #fff2cc;\" colspan=\"3\"><b>Adult Patients<\/b><\/td>\n<\/tr>\n<tr>\n<td>Disease-free after 10 years<\/td>\n<td>64%<\/td>\n<td>21%<\/td>\n<\/tr>\n<tr>\n<td>Alive after 10 years<\/td>\n<td>60%<\/td>\n<td>15%<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table>\n<tbody>\n<tr>\n<td style=\"background-color: #00b0f0;\" rowspan=\"2\"><b>Patient age<\/b><\/td>\n<td style=\"background-color: #00b0f0;\" colspan=\"2\"><b>Hazard ratios<\/b><\/td>\n<\/tr>\n<tr>\n<td style=\"background-color: #00b0f0;\"><b>EFS (Event-Free Survival)<\/b><\/td>\n<td style=\"background-color: #00b0f0;\"><b>OS (Overall Survival)<\/b><\/td>\n<\/tr>\n<tr>\n<td>Pediatric patients<\/td>\n<td>0.23<\/td>\n<td>0.28<\/td>\n<\/tr>\n<tr>\n<td>Adult patients<\/td>\n<td>0.28<\/td>\n<td>0.28<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p style=\"font-weight: 400;\">On MRD status, hazards are much higher for adult patients than for pediatric patients in the first 3 years. Hazards for adults were comparable or possibly even lower than for pediatric patients in subsequent years.<\/p>\n<p>Also, the relationship between MRD and EFS can be exploited for the following:<\/p>\n<ul>\n<li>In clinical practice, assigning patients who have MRD to alternative therapy, perhaps an allograft or a clinical trial.<\/li>\n<li>As a research tool for better defining patients at high risk for recurrence and eligibility for clinical trials.<\/li>\n<li>Assigning the highest priority for definitive evaluation in phase 3 trials for therapies that achieve the lowest rates of MRD.<\/li>\n<li>Providing supportive data in regulatory decisions based primarily on complete response rates with incomplete hematological recovery (as in the approval of blinatumomab).<\/li>\n<li>Extrapolating from disease types where therapy has a known effect on other hematological malignant diseases where it shows a benefit on MRD.<\/li>\n<\/ul>\n<p>The full article can be accessed at: <a href=\"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2626509\" target=\"_blank\" rel=\"noopener\">https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2626509<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>SUBURBAN JOURNAL CLUB A monthly precis of some of the best, most influential journal articles. Journal Article: Association Of Minimal Residual Disease With Clinical Outcome In Pediatric &amp; Adult Acute Lymphoblastic Leukemia: A Meta-analysis Journal: JAMA Oncology, Volume 3, 2017 DOI: 10.1001\/jamaoncol.2017.0580 Introduction: Minimal residual disease (MRD) refers to the presence of disease in cases<span class=\"post-excerpt-end\">&hellip;<\/span><\/p>\n<p class=\"more-link\"><a href=\"https:\/\/www.suburbandiagnostics.com\/blog\/pediatric-and-adult-acute-lymphoblastic-leukemia\/\" class=\"themebutton\">Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":2133,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-2123","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-for-doctors"],"blog_post_layout_featured_media_urls":{"thumbnail":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia-150x150.webp",150,150,true],"full":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia.webp",1000,600,false]},"categories_names":{"5":{"name":"For Doctors","link":"https:\/\/www.suburbandiagnostics.com\/blog\/for-doctors\/"}},"tags_names":[],"comments_number":"0","rttpg_featured_image_url":{"full":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia.webp",1000,600,false],"landscape":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia.webp",1000,600,false],"portraits":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia.webp",1000,600,false],"thumbnail":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia-150x150.webp",150,150,true],"medium":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia-300x180.webp",300,180,true],"large":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia.webp",1000,600,false],"1536x1536":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia.webp",1000,600,false],"2048x2048":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia.webp",1000,600,false],"shuttle-column1-1\/3":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia-1000x380.webp",1000,380,true],"shuttle-column1-1\/4":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia-1000x285.webp",1000,285,true],"shuttle-column2-1\/2":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia-570x285.webp",570,285,true],"shuttle-column2-2\/3":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia-570x380.webp",570,380,true],"shuttle-column3-1\/3":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia-380x107.webp",380,107,true],"shuttle-column3-2\/3":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia-380x254.webp",380,254,true],"shuttle-column4-2\/3":["https:\/\/www.suburbandiagnostics.com\/blog\/wp-content\/uploads\/2024\/12\/Pediatric-Adult-Acute-Lymphoblastic-Leukemia-285x190.webp",285,190,true]},"rttpg_author":{"display_name":"Suburban","author_link":"https:\/\/www.suburbandiagnostics.com\/blog\/author\/suburban\/"},"rttpg_comment":0,"rttpg_category":"<a href=\"https:\/\/www.suburbandiagnostics.com\/blog\/for-doctors\/\" rel=\"category tag\">For Doctors<\/a>","rttpg_excerpt":"SUBURBAN JOURNAL CLUB A monthly precis of some of the best, most influential journal articles. Journal Article: Association Of Minimal Residual Disease With Clinical Outcome In Pediatric &amp; Adult Acute Lymphoblastic Leukemia: A Meta-analysis Journal: JAMA Oncology, Volume 3, 2017 DOI: 10.1001\/jamaoncol.2017.0580 Introduction: Minimal residual disease (MRD) refers to the presence of disease in cases&hellip;Read&hellip;","_links":{"self":[{"href":"https:\/\/www.suburbandiagnostics.com\/blog\/wp-json\/wp\/v2\/posts\/2123","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.suburbandiagnostics.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.suburbandiagnostics.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.suburbandiagnostics.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.suburbandiagnostics.com\/blog\/wp-json\/wp\/v2\/comments?post=2123"}],"version-history":[{"count":10,"href":"https:\/\/www.suburbandiagnostics.com\/blog\/wp-json\/wp\/v2\/posts\/2123\/revisions"}],"predecessor-version":[{"id":4309,"href":"https:\/\/www.suburbandiagnostics.com\/blog\/wp-json\/wp\/v2\/posts\/2123\/revisions\/4309"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.suburbandiagnostics.com\/blog\/wp-json\/wp\/v2\/media\/2133"}],"wp:attachment":[{"href":"https:\/\/www.suburbandiagnostics.com\/blog\/wp-json\/wp\/v2\/media?parent=2123"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.suburbandiagnostics.com\/blog\/wp-json\/wp\/v2\/categories?post=2123"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.suburbandiagnostics.com\/blog\/wp-json\/wp\/v2\/tags?post=2123"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}