International cooperative study identifies treatment strategy in childhood ambiguous lineage leukemia by Ondrej Hrusak, Valerie de Haas, Jitka Stancikova,

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Presentation transcript:

International cooperative study identifies treatment strategy in childhood ambiguous lineage leukemia by Ondrej Hrusak, Valerie de Haas, Jitka Stancikova, Barbora Vakrmanova, Iveta Janotova, Ester Mejstrikova, Vaclav Capek, Jan Trka, Marketa Zaliova, Ales Luks, Kirsten Bleckmann, Anja Möricke, Julie Irving, Benigna Konatkowska, Thomas B. Alexander, Hiroto Inaba, Kjeld Schmiegelow, Simone Stokley, Zuzana Zemanova, Anthony V. Moorman, Jorge Gabriel Rossi, Maria Sara Felice, Luciano Dalla-Pozza, Jessa Morales, Michael Dworzak, Barbara Buldini, Giuseppe Basso, Myriam Campbell, Maria Elena Cabrera, Neda Marinov, Sarah Elitzur, Shai Izraeli, Drorit Luria, Tamar Feuerstein, Alexandra Kolenova, Peter Svec, Olena Kreminska, Karen R. Rabin, Sophia Polychronopoulou, Elaine da Costa, Hanne Vibeke Marquart, Antonis Kattamis, Richard Ratei, Dirk Reinhardt, John K. Choi, Martin Schrappe, and Jan Stary Blood Volume 132(3):264-276 July 19, 2018 ©2018 by American Society of Hematology

Ondrej Hrusak et al. Blood 2018;132:264-276 ©2018 by American Society of Hematology

Flowchart. Flowchart. Rectangles contain selection criteria in each step, followed by the number of patients in parentheses. Tables or figures mentioned next to each rectangle depict all patients from the respective node unless a selection is specified in a footnote. Ondrej Hrusak et al. Blood 2018;132:264-276 ©2018 by American Society of Hematology

Outcome of patients with ALAL by the primary type of treatment. Outcome of patients with ALAL by the primary type of treatment. (A) EFS. (B) Overall survival. A log-rank (Mantel-Cox) statistical test was used. Ondrej Hrusak et al. Blood 2018;132:264-276 ©2018 by American Society of Hematology

Outcome of patients with ALAL on different treatment types. Outcome of patients with ALAL on different treatment types. Single-population ALAL vs bilineal ALAL. (A) EFS. (B) Overall survival. A log-rank (Mantel-Cox) statistical test was used. Ondrej Hrusak et al. Blood 2018;132:264-276 ©2018 by American Society of Hematology

Outcome of children with CD19+ ALAL and CD19−ALAL with other lymphoid-specific antigens by the type of primary therapy. Outcome of children with CD19+ALAL and CD19−ALAL with other lymphoid-specific antigens by the type of primary therapy. Patients without ETV6/RUNX1, RUNX1/RUNX1T1, PML/RARA, or BCR/ABL1 gene fusions. A log-rank (Mantel-Cox) statistical test was used. (A) EFS of CD19+ ALAL. (B) EFS of CD 19− ALAL with other lymphoid-specific antigens. (C) Overall survival of CD19+ patients. (D) Overall survival of CD19− ALAL with other lymphoid-specific antigens. Other lymphoid-specific antigens are listed in “Results.” Ondrej Hrusak et al. Blood 2018;132:264-276 ©2018 by American Society of Hematology

Outcome of ALAL patients transplanted in the first complete remission compared with other patients. Outcome of ALAL patients transplanted in the first complete remission compared with other patients. In each type of primary treatment, events occurring prior to the median time to transplant were neglected. A log-rank (Mantel-Cox) statistical test was used. (A) ALL treatment type EFS. (B) Combined-type treatment EFS. (C) EFS. (D) ALL treatment type overall survival. (E) Combined-type treatment overall survival. (F) AML treatment type overall survival. Ondrej Hrusak et al. Blood 2018;132:264-276 ©2018 by American Society of Hematology

Outcome of ALAL patients in relation to their response to prednisone. Outcome of ALAL patients in relation to their response to prednisone. (A) CD19+ EFS. (B) CD19− EFS. (C) CD19+ overall survival. (D) CD19− overall survival. A log-rank (Mantel-Cox) statistical test was used. Ondrej Hrusak et al. Blood 2018;132:264-276 ©2018 by American Society of Hematology

Treatment recommendation algorithm. Treatment recommendation algorithm. After each decision node, the number (percentage) of patients who still remain to be categorized is given. Note that the algorithm shows a recommendation to be tested prospectively and does not refer to the way in which patients in this study were treated. Numbers (percentages) include all 233 patients in the study with confirmed inclusion criteria. Neg, negative; pos, positive (or partly positive). TKI, tyrosine kinase inhibitor. Ondrej Hrusak et al. Blood 2018;132:264-276 ©2018 by American Society of Hematology