612. Acute Lymphoblastic Leukemias: Clinical and Epidemiological: Clinical, genetic and societal risk factors impacting ALL outcomes
Sumit Gupta, David T. Teachey, Meenakshi Devidas, et al.
The reasons for the outcome disparities between certain disadvantaged groups mentioned in the title of the study are different. According to the study authors, further studies are needed to identify specific causes for differences in survival so that the differences can be reduced through targeted interventions.
Biqi Zhou, Xinran Chu, Hong Tian, et al.
Age, extent of MRD, and DNA repair gene mutations are related to E2A-PBX1 positive B-ALL outcomes. Allo-HSCT, especially haploidentical-HSCT, would optimize the prognosis.
213 ASH denotes this abstract as clinically relevant:
Aman Wadhwa, Yanjun Chen, Lindsey Hageman, et al.
More research is needed to understand the mechanism of the relationship between morbid obesity during maintenance and the risk of relapse in children with ALL. The study shows that in the context of ALL maintenance therapy, morbid obesity is associated with relapses. There is also a lower systemic exposure to 6MP. Lower TGN (red cell thioguanine) values cannot explain the relationship between BMI and the risk of relapse.
Shaobo Li, Pagna Sok, Keren Xu, et al.
If, according to the DNA methylation data, increased B-cell proportions are found in newborns with Down syndrome (DS), this can be a risk factor for the development of DS-ALL in childhood. This finding should be investigated as a new biomarker for ALL risk in the non-DS population. However, it needs to be confirmed by conventional cell count measurements.
Corentin Orvain, Sylvain Chantepie, Xavier Thomas, et al.
Pediatric-inspired protocols in the treatment of young adults with ALL have a poor risk of CNS involvement and historical use of allogeneic SCT does not improve outcomes. Treatment regimens tailored to adults with CNS involvement need to be developed.
Sabina Chiaretti, Massimiliano Bonifacio, Roberta Agrippino, et al.
The incidence of SARS-CoV-2 infection in adult ALL patients does not differ significantly from that of the general population. The contagion - mostly during the second wave of the pandemic - was mainly nosocomial. The mortality was 11%. It follows that ALL should be treated mainly on an outpatient basis.
As observed earlier, it is striking that Ph + ALL patients were better cared for with fewer treatment interruptions. This points to an advantage of the TKI-based induction / consolidation strategy without systemic chemotherapy in Ph + ALL, which is used in the GIMEMA protocols (Gruppo Italiano Malattie EMatologiche dell'Adulto), and also establishes a possible protective function of TKIs in COVID-19-Infected patients.