Protocol ALL-IC BFM 2002: Outcomes of Pediatric Acute Lymphoblastic Leukemia Treatment under Multi-Center Clinical Trial

Валиев, Т. Т.; Шервашидзе, М. А.; Осипова, И. В.; Burlutskaya, T. I.; Попова, Н. А.; Osmulskaya, N. S.; Алескерова, Г А; Sabantsev, S. L.; Гордеева, З С; Smirnov, V.Yu.; Poberezhnaya, O. A.; Yuldasheva, S. N.; Babich, I. A.; Батманова, Н. А.; Варфоломеева, С. Р.

doi:10.21320/2500-2139-2022-15-2-119-129

Cited by 13 publications

(1 citation statement)

References 8 publications

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“…The peripheral blast count on the 8th day of chemotherapy was <1000/µL, and the percentage of blasts in myelogram at 15 days of treatment was <2%. Intensive chemotherapy according to the ALL-IC-BMF 2009 protocol [6] concluded in July 2016. In January 2017, a very early isolated BM relapse was diagnosed, and a subsequent genetic analysis of somatic karyotype and microarrays revealed previously non-existent karyotype changes: 46,XY,t(9;17)(p10;p10).…”

Section: Case Presentationmentioning

confidence: 99%

Relapse/Refractory Paediatric B-ALL Case with CD19− Phenotype Switching Indicating the Importance of Appropriate Diagnostic Approach and Targeted Treatment Adjustment—Case Report

Prażmo,

Jawoszek,

Styka

et al. 2023

IJMS

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The case reported presents a rare CD19− phenotype shift of an acute lymphoblastic leukaemia clone during relapse/refractory ALL in a paediatric patient. We explore possible reasons for the promotion of CD19-negative cell selection, including discrete mutations and anti-CD19 treatment, which is gaining importance as targeted therapies such as blinatumomab enter standard treatment protocols. A 9-year-old male patient was diagnosed with B lymphocyte acute lymphoblastic leukaemia. Initial standard genetic analysis did not show significant chromosomal aberrations, and the patient underwent chemotherapy in line with the intermediate-risk protocol. After initially achieving remission, the disease relapsed, and the patient required hematopoietic stem cell transplantation (HSCT). In-depth retrospective microarray analysis performed at this point revealed additional risk factors, particularly a loss of function TP53 V173L mutation. A second recurrence was diagnosed which prompted targeted treatment application (blinatumomab) and subsequent HSCT. The third leukemic relapse, diagnosed shortly after the second HSCT, limited treatment options to last-resort CAR T-cell therapy in Germany. Subsequent immunophenotyping revealed insufficient CD19 expression by ALL clones and disqualified the patient from treatment. The patient died in October 2019 from disease progression. The case highlights the importance of in-depth molecular diagnostics and monitoring of relapse/recurrent ALL cases to identify and manage risk factors during treatment.

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Section: Case Presentationmentioning

confidence: 99%

Relapse/Refractory Paediatric B-ALL Case with CD19− Phenotype Switching Indicating the Importance of Appropriate Diagnostic Approach and Targeted Treatment Adjustment—Case Report

Prażmo,

Jawoszek,

Styka

et al. 2023

IJMS

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Immunological aspects of hematopoietic stem cell transplantation for hematologic malignancies and some immunological peculiarities of cancer radioimmunotherapy

Ширин

Baranova

Reshetnikova

2023

Rossijskij bioterapevtičeskij žurnal

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This literature review provides basic information about the role of hematopoietic stem cell transplantation in the treatment of myelodysplastic syndromes, acute myeloid leukemia, acute lymphoblastic leukemia. The recommendations for the use of stem cell transplantation are indicated. Conditioning regimens (myeloablative, non-myeloablative, reduced intensity), their advantages and disadvantages are considered. The issues of prevention and treatment of graft-versus-host disease, including graft preparation (T-cell depletion), extracorporeal photopheresis and mechanisms of graft-versus-tumor (-leukemia) reaction are highlighted. The historical milestones of theimmunotherapy development, the creation of therapeutic monoclonal antibodies, the development of targeted therapy, for example, conjugates of monoclonal antibodies with cytostatic drugs and radionuclides (targeted radionuclide therapy) are reported. Information about radioimmunotherapy as a method used for treatment of solid tumors and non-Hodgkin’s lymphoma, and information on the use of mesenchymal stem cells for the treatment and prevention of the graft-versus-host reaction are presented.

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Toxicity assessment of acute lymphoblastic leukemia treatment protocol ALL IC-BFM 2002

2022

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Background. Treatment results of acute lymphoblastic leukemia in children on protocol, developed by one of the leading research study group BFM (Berlin-Frankfurt-Munster) are impressive - longstanding overall survival rate comprise 93.4 %. The basis of success is a differential approach based on prognostic factors. In some local issues BFM protocols receive criticism because of high toxicity, but trying to find results of complex protocol toxicity assessment by modern scales in local literature, it was absent.Aim. To study a toxicity of acute lymphoblastic leukemia treatment by ALL IC-BFM 2002 protocol.Materials and methods. 119 patients with primary diagnosed acute lymphoblastic leukemia were enrolled the study. All the patients were treated by ALL IC-BFM 2002 protocol. Toxicity assessment was performed by the scale of National Cancer Institute (NCI) USA, 2nd version.Results. The most often variants of toxicity during treatment according to the ALL IC-BFM 2002 protocol were myelo-suppression, infections and hepatotoxicity of I-IV degrees of severity. Clinically significant toxicity (grade IV) was myelosuppression and necessity for transfusions in 76.8-100 % (depending on prognostic risk group and as such protocol arm). Nephro- and hepatotoxicity described on high-dosed methotrexate (2000 mg/m2 or 5000 mg/m2) were I-II grade in 89.5 % patients. Stomatitis grade I-II was in 93.7 % patients of standard and intermediate risk groups, but in the most (90 %) patients from high risk group it was higher - grade III-IV. Mortality on protocol ALL IC-BFM 2002 caused by infection complications was 1.6 %. It should be noted, that supportive care, prescribed in ALL IC-BFM 2002 protocol help to prevent and correct severe toxicity effectively.Conclusion. The toxicity profile of ALL IC-BFM 2002 protocol, analyzed by frequency of toxicity grade III-IV with whole supportive care approaches, is acceptable. The noted variants of toxicity were fully resolved without irreversible consequences for the patients.

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Protocol ALL-IC BFM 2002: Outcomes of Pediatric Acute Lymphoblastic Leukemia Treatment under Multi-Center Clinical Trial

Cited by 13 publications

References 8 publications

Relapse/Refractory Paediatric B-ALL Case with CD19− Phenotype Switching Indicating the Importance of Appropriate Diagnostic Approach and Targeted Treatment Adjustment—Case Report

Relapse/Refractory Paediatric B-ALL Case with CD19− Phenotype Switching Indicating the Importance of Appropriate Diagnostic Approach and Targeted Treatment Adjustment—Case Report

Immunological aspects of hematopoietic stem cell transplantation for hematologic malignancies and some immunological peculiarities of cancer radioimmunotherapy

Toxicity assessment of acute lymphoblastic leukemia treatment protocol ALL IC-BFM 2002

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