ORLANDO—A gene-profiling chip might help identify children with acute lymphoblastic leukemia (ALL) who are at low risk of relapse and could be spared intensive therapy, or who are at high risk for treatment-induced acute myeloid leukemia (AML) and should not be treated with topoisomerase II inhibitors.
In a plenary presentation at the 43rd Annual Meeting of the American Society of Hematology (abstract 1816), Allen Eng-Juh Yeoh, MD, said that a limited number of genes determine risk in these two areas, and that this might permit development of an inexpensive, simple test that could be used in developing countries as well as in the United States.
Carolyn A. Felix, MD, who introduced Dr. Yeoh’s paper, said that it "takes gene expression profiling to the next level by defining biologic variables that affect prognosis." Dr. Felix is associate professor of pediatrics, Children’s Hospital, Philadelphia.
Dr. Yeoh was presented with an ASH Merit Award for this study, which was done in the laboratory of John R. Downing, MD, at St. Jude Children’s Research Hospital, Memphis. Dr. Yeoh is a clinical fellow in the Departments of Hematology-Oncology and Pathology at St. Jude and assistant professor of pediatrics, National University of Singapore.
Dr. Yeoh said that the 80% cure rate for pediatric ALL achieved at St. Jude and other institutions is the result of stratifying patients by leukemia subtype and tailoring treatment accordingly, but, he added, this requires extensive laboratory studies.
The approach pioneered by his group opens the possibility that a single test might replace molecular screening, immunotyping, and related assays, and also enable the clinician to identify patients with a high risk of relapse and with a high vulnerability to treatment-induced secondary AML.
Study Methods
