Cailin Conner

AZUHT-PRODUCTIONwarmup

According to a study published in the Journal of Clinical Oncology, despite advancements in therapy, the prognosis for induction failure (IF) in childhood T-cell acute lymphoblastic leukemia (ALL) remains poor. “The lack of a unifying genetic driver suggests alternative approaches, particularly using immunotherapy, are urgently needed,” the investigators wrote.
With the goal of addressing the limited understanding of clinical and genetic factors that influence outcome in a cohort of patients with T-cell ALL IF, investigators examined all cases of T-cell ALL IF in 2 randomized trials (UKALL2003 and UKALL2011) to identify risk factors, treatments, and outcomes.
The results of the study revealed that IF occurred in 10.3% of T-cell ALL cases. Additionally, IF occurred in 20% of patients with T-cell ALL aged &gt;16 years, suggesting that age may play a role in treatment resistance.
Despite the increased utilization of nelarabine-based chemotherapy followed by hematopoietic stem cell transplantation in the randomized UKALL2011 trial, there was no observable enhancement in the overall treatment outcome. The presence of persistent molecular residual disease at the end of consolidation treatment was linked to a notably worse prognosis (5-year overall survival [OS] rate, 14.3% vs 68.5%; hazard ratio [HR], 4.10; 95% CI, 1.35-12.45; P=.0071).
Genomic profiling showed 25 distinct initiating anomalies, which converged on 10 subtype-defining genes. Notably, an abundance of TAL1 noncoding anomalies was identified, and these anomalies were associated with an unfavorable prognosis (5-year OS rate, 12.5%). When TAL1 anomalies were combined with mutations in the MYC and RAS pathways, a genetic stratification emerged that could effectively identify patients highly likely to experience treatment failure (5-year OS rate, 23.1% vs 86.4%; HR, 6.84; 95% CI, 2.78-16.78; P&lt;.0001).
“The abysmal outcome in those relapsing after IF emphasizes that there is only 1 opportunity to cure these patients and better therapies are urgently needed to achieve this. The lack of progress made in relapsed [or] refractory [T-cell ALL] over the past 2 decades contrasts starkly with the influx of efficacious immunotherapies in [B-cell ALL],” the investigators wrote. “Thankfully, similar agents are now on the horizon for [T-cell ALL] with monoclonal antibodies and CAR T cells entering the clinical arena.”
Source: <a href="https://ascopubs.org/doi/10.1200/JCO.22.02734" target="_blank" rel="noopener">Journal of Clinical Oncology</a>

Katie Kosko

African American Patients With RCC at Increased Risk of Death

SUO 2024

Bladder Cancer Clinical Trials Are Limited in Highly Vulnerable US Counties

Racial, Gender Disparities Are Common During Hematuria Evaluation

Latest News

Unfavorable Prognosis in Childhood T-Cell ALL Persists Despite Advancements in Treatment

Blood Cancers

The prognosis for induction failure in childhood T-cell acute lymphoblastic leukemia remains unfavorable despite advancements in treatment strategies.

About Us

Editorial Policy

Contributors & Partners

eNewsletters

Contact Us

Work With Us

Advertising

GU Oncology Now

Blood Cancers Today

Cancer Nursing Today

DocWire News

MashupMD

Food Allergy Roundtable Discussions

Autoimmune Disease

Allergy

— Multiple Myeloma

Breast Cancer

Colorectal Cancer

Lung Cancer

Pancreatic Cancer

Prostate Cancer

Cancer

Diabetes

Heart Failure

Heart Disease Prevention

Heart Health

HIV Roundtable Discussions

COVID-19

Infectious Diseases

Asthma

COPD

Pulmonology

Digital Health

Workforce News

Public Health

Dermatology

Gastroenterology

Kidney Disease

Neurology

Obesity

Pediatrics

Sickle Cell Disease

Eye Disease

Video Insights

More

Gynecologic Cancer

Heart Disease in Women

Menopause

Reproductive Health

Women’s Neurology

Well Woman Today

Roundtables

Podcasts

Conferences

Viewpoints

Career Center

Subscribe