The following article features coverage from the AACR Annual Meeting 2022. Click here to read more of Cancer Therapy Advisor’s conference coverage.

In a multiethnic study of patients with acute lymphoblastic leukemia (ALL), researchers identified factors associated with relapse risk.1,2

Overall, the risk of relapse was higher among patients who had minimal residual disease (MRD), were older, and had high-risk status. Among patients who were MRD negative, Latino patients were more likely to relapse than non-Latino White patients.

Results of this study were presented at the AACR Annual Meeting 2022 by Pagna Sok, MPH, of Baylor College of Medicine in Houston, and colleagues.1


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The researchers noted that the strongest prognostic factor for relapse of ALL is the presence of MRD at the end of induction, but MRD negativity is found in approximately half of all children who relapse. The researchers undertook this analysis to explore risk factors for relapse in this patient population.

The study was based on data from patients with ALL from the Reducing Ethnic Disparities in Acute Leukemia (REDIAL) Consortium, which includes 6 pediatric centers throughout the southwestern United States. Included patients were 1 to 23 years of age at the time of ALL diagnosis. The researchers considered multiple demographic and clinical factors in their analysis of possible risk factors for relapse.

A total of 1710 patients with ALL were identified in the analysis, and they had a median age of 5 years at diagnosis. More than half (60.1%) of patients in the analysis were Latino. There were 379 patients with MRD positivity and 1233 with MRD negativity.

The rate of relapse was significantly higher among patients who were MRD positive (n=379) than among those who were MRD negative (n=1233) — 19.5% and 11.2%, respectively (P <.0001). However, approximately 65% of relapses occurred in patients with MRD negativity.

An adjusted analysis revealed a few factors that were associated with relapse. A higher relapse risk was seen with older age at diagnosis (hazard ratio [HR], 1.98; 95% CI, 1.19-3.29 for younger than 15 versus 1-5 years of age), MRD positivity (HR, 1.72; 95% CI, 1.26-2.36), and National Cancer Institute (NCI) high-risk status (HR, 1.74; 95% CI, 1.20-2.52).1 However, enrollment on a clinical trial was associated with a lower risk of relapse (HR, 0.76; 95% CI, 0.57-0.99).

In patients with MRD positivity, there was a lower risk of relapse among Latino patients (HR, 0.60; 95% CI, 0.33-0.99) than among non-Latino White patients. Among MRD-negative patients, the Latino group had a greater relapse risk (HR, 1.68; 95% CI, 1.09-2.59).

“We were surprised that Latinos who were MRD negative were more likely to experience ALL relapse compared to non-Latino whites,” lead study author Phillip Lupo, PhD, said in a press release.2 “This highlights the need to identify factors that contribute to relapse among Latinos so that we can achieve better outcomes for children of all racial and ethnic backgrounds.”

Read more of Cancer Therapy Advisor’s coverage of AACR 2022 by visiting the conference page.

References

  1. Sok P, Brown AL, Taylor OA, et al. Disparities in relapse among a large multi-ethnic population of children diagnosed with acute lymphoblastic leukemia (ALL): a report from the Reducing Ethnic Disparities in Acute Leukemia (REDIAL) Consortium. Presented at AACR 2022; April 8-13, 2022. Abstract 3633.
  2. Some Latino children diagnosed with acute lymphoblastic leukemia face higher risk of relapse compared to non-Latino White children. News release. AACR; April 12, 2022.

This article originally appeared on Hematology Advisor