In pediatric patients with newly diagnosed B-cell ALL and underlying Lynch syndrome, how does the MMR deficiency inform your treatment planning and survivorship surveillance?

Treat B-cell ALL with chemotherapy appropriate for risk category and usual follow-up.

• MRI Brain Q 6 months up to age 20, then annually
• Colonoscopy annually starting at age 6 years
• Upper endoscopy at age 10 years and annually
• Whole body low dose MRI annually
• Physical examination and skin exam every ...