Prognostic Impact of the Genetic Risk at Baseline Associated to the MRD Clearance in Adult Patients with Newly Diagnosed Acute Lymphoblastic Leukemia. Preliminary Results of Pethema LAL19 Trial

• Published in: Blood 2024-11, Vol.144, p.962-962
• Main Authors: Torrent, Anna, Morgades, Mireia, Soriano, Beatriz, Ribera, Jordi, Barrera, Susana, Montesinos, Pau, Genescà, Eulàlia, González-Campos, José, Barba, Pere, Esteve, Jordi, Sitges, Marta, Queipo De Llano, Maria Paz, Botella, Carmen, Maluquer Artigal, Clara, García-Cadenas, Irene, Calabuig, Marisa, Hernández Sánchez, Alberto, Torres, Laura, Granada, Isabel, Hernandez Rivas, Jesus Maria, Orfao, Alberto, Ribera, Josep-Maria
• Format: Article
• Language: English
• ISSN: 0006-4971
• DOI: 10.1182/blood-2024-205124

Introduction. Young and middle-aged adults with ALL (18-60 years) who receive a pediatric-inspired chemotherapy (CHT) regimen for treatment of Ph-neg ALL do not appear to require an alloHSCT if they had a negative MRD after induction therapy. It is not clear if the genetic risk at baseline associated with this MRD approach, would allow identifying with more accuracy those patients who will receive CHT or alloHSCT. The aim of the prospective LAL19 trial from the Spanish PETHEMA Group was to evaluate the outcomes of pts assigned to a differentiated post-induction therapy (chemotherapy or alloHSCT) according to MRD levels (assessed by 8-color, centrally-performed flow cytometry at the end of induction -week 5- and consolidation therapy -week 17-) and genetic features at diagnosis. Patients and methods. Pts with HR genetic features and/or those without good MRD response (MRD≥0.01% at end of induction-1 (ind-1) and ≥0.001% at end of consolidation) were assigned to receive an alloHSCT after consolidation. Pts with genetic HR features included for B-ALL: KMT2A translocation, near/low hypodiploidy (