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Topics:
Hematologic Malignancies • Pediatric Hematology/Oncology • Medical Oncology • Bone Marrow Transplant • AML • ALL • Hematology
Would you recommend an allogenic stem cell transplant in an older patient > 50 with Ph negative acute lymphoblastic leukemia who is MRD negative after induction?
Does your answer change based on clinical or molecular risk factors, and if so how?
Does your answer change if MRD status after induction is unknown?
Answer from: Medical Oncologist at Academic Institution
Assuming that the patient has standard-risk disease, there is no clear consensus regarding the optimal consolidation therapy for these patients. Consolidation chemotherapy produces 4-year survival rates of ~50%. If ALL achieves MRD-negativity early on, I generally recommend chemotherapy alone, espec...
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Answer from: Medical Oncologist at Academic Institution
In general, I would not routinely recommend allogeneic hematopoietic cell transplantation (HCT) for Ph- acute lymphoblastic leukemia (ALL) that is in MRD-negative remission this early in their treatment. This sort of response demonstrates significant chemosensitivity. Therefore, I would favor contin...