Popov et al identified pediatric patients with acute lymphoblastic leukemia (ALL) who can be cured with low-intensity therapy. The authors are from multiple institutions in Russia and Germany.
Patient selection: pediatric patient with ALL
Criteria for the "standard" risk group - all of the following:
(1) B-cell precursor type
(2) initial WBC count < 30 * 10^9/L
(3) spleen less than 4 cm below the left costal margin
(4) no CNS3 status (with no clinical or radiological evidence of CNS involvement)
(5) no translocation: t(4;11)(q21;q23) nor t(9;22)(q34;q11)
(6) hematologic remission at the end of induction (typically day 36)
where:
• MRD negativity was defined as < 0.01%.
• A low-risk cutoff < 0.1% (0.01 to 0.099%) also had excellent results.
• Based on Table 1 the < 0.1% criteria was used.
This risk group encompasses > 40% of children with ALL. At least 90% will be excellent responders with an overall survival of 97%.
