Results of two consecutive treatment protocols in Polish children with acute lymphoblastic leukemia

Area of Science:

• Pediatric Oncology
• Hematology
• Clinical Trials

Background:

• Acute lymphoblastic leukemia (ALL) treatment protocols evolve to improve patient outcomes.
• Comparing treatment protocols is essential for optimizing pediatric ALL care.
• Minimal residual disease (MRD) is a critical prognostic factor in ALL treatment.

Purpose of the Study:

• To compare the effectiveness of the ALL IC-BFM 2002 and ALL IC-BFM 2009 protocols in pediatric ALL patients.
• To analyze the impact of MRD measurement on survival outcomes under different protocols.
• To evaluate the distribution of risk groups based on MRD levels between the two protocols.

Main Methods:

• Retrospective analysis of medical records from 3248 pediatric ALL patients (aged 1-18 years) treated between 2002 and 2018 in Poland.
• Comparison of overall survival (OS) and event-free survival (EFS) rates between patients treated with ALL IC-BFM 2002 and ALL IC-BFM 2009 protocols.
• Assessment of minimal residual disease (MRD) by flow cytometry (FCM-MRD) on day 15 of treatment.

Main Results:

• The ALL IC-BFM 2009 protocol demonstrated significantly higher 3-year overall survival (87%) compared to the ALL IC-BFM 2002 protocol (84%) (P < 0.001).
• Event-free survival rates were also improved with the 2009 protocol (84%) versus the 2002 protocol (82%) (P = 0.006).
• MRD assessment on day 15 was confirmed as an important predictive factor for survival outcomes.

Conclusions:

• The ALL IC-BFM 2009 protocol represents an improvement over the ALL IC-BFM 2002 protocol for treating pediatric ALL in Poland.
• Early MRD assessment using FCM-MRD is crucial for predicting treatment response and guiding therapy adjustments in pediatric ALL.
• Continued evaluation of treatment protocols and prognostic markers is vital for advancing pediatric ALL care.