ASH 2024 | The prognostic impact of genetic risk at baseline is associated with MRD clearance in adult Ph- ALL
In this interview, Josep-Maria Ribera, MD, PhD, Germans Trias i Pujol University Hospital, Barcelona, Spain, comments on data from the PETHEMA LAL19 trial (NCT04179929), suggesting that traditional therapy for adult Philadelphia chromosome-negative (Ph-) acute lymphoblastic leukemia (ALL), which relies on monitoring measurable residual disease (MRD) clearance post-induction and post-consolidation, is insufficient for making decisions regarding post-consolidation therapy. By incorporating genetic risk assessment, Prof. Ribera’s team stratified patients by MRD and genetics, identifying a subgroup with excellent outcomes, regardless of MRD levels. This implies that a combination of MRD and genetics is necessary for appropriate therapeutic stratification. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript (AI-generated)
What is the solution for the therapy? We think that in adult ALL without Philadelphia chromosome, traditionally the therapy weight is made by MRD- the results of MRD during, after induction and after consolidation. We consider that this was not sufficient for the allocation of the post-consolidation therapy/therapies in patients that achieved a good complete response...
What is the solution for the therapy? We think that in adult ALL without Philadelphia chromosome, traditionally the therapy weight is made by MRD- the results of MRD during, after induction and after consolidation. We consider that this was not sufficient for the allocation of the post-consolidation therapy/therapies in patients that achieved a good complete response. So we consider that genetics has an independent impact on the value of MRD in order to select the most appropriate therapy. And for that reason, we are stratifying the patients according not only by MRD, but also by genetics. And then we demonstrated that there is a subgroup of patients that have a good MRD level and a good standard genetic profile that have a very, very good outcome. And this was different from also the patients who were also measured by MRD. Our conclusion is that for therapeutic stratification, we will need MRD and genetics in order to properly treat our patients.
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