EHA 2026 | Outcomes and risk factors in children and young adults with ALL and high-risk genetics
Anthony Moorman, PhD, Newcastle University, Newcastle, UK, provides insight into a study of outcomes and risk factors in children and young adults with acute lymphoblastic leukemia (ALL) and high-risk genetics, highlighting that patients with near-haploidy or low-hypodiploidy continue to have the poorest outcomes despite intensive chemotherapy. Prof. Moorman notes that this subgroup also appears to be resistant to both chemotherapy and immunotherapy, which is a major concern, as they may not respond to novel therapies such as blinatumomab. This interview took place at the 31st Congress of the European Hematology Association (EHA) in Stockholm, Sweden.
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Transcript
Yes, so that was a particularly interesting study that we did, because what we tried to do is collect a large cohort of patients that had one of the classic high-risk genetics, and we did it over a very long period of time. So we were able to show that with increasing levels of risk stratification, i.e. treating these patients with more intensive chemotherapy, most of them had an improved outcome with that extra chemotherapy...
Yes, so that was a particularly interesting study that we did, because what we tried to do is collect a large cohort of patients that had one of the classic high-risk genetics, and we did it over a very long period of time. So we were able to show that with increasing levels of risk stratification, i.e. treating these patients with more intensive chemotherapy, most of them had an improved outcome with that extra chemotherapy. So that was really encouraging. The one group that kind of didn’t improve as much as others were the group that had either near haploidy, so that’s less than 30 chromosomes, or low hypodiploidy, 30 to 39 chromosomes. So this is actually a very small number of children with acute lymphoblastic leukemia. And it’s interesting to note that in some of the other abstracts that have been presented here, and some of the recent papers where they’ve introduced blinatumomab therapy, that is still one of the subtypes that seems to have the most resistance to both chemotherapy and immunotherapy. This is a big issue in adult ALL where low hypodiploidy accounts for about 10 to 15% of older adults, so that’s going to be a real sticking point because blinatumomab is the major change in the therapy of ALL over the past few years. And if that group really is resistant to blinatumomab therapy, then that is the one group that is going to need additional attention.
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Disclosures
Speaker honoraria: Amgen.
