ALL-IC relapsed ALL project
The Acute Lymphoblastic LeukAemia Inter Continental (ALL-IC) Study Group is nearing completion of its second frontline ALL trial. By standardizing therapy and involving flow cytometry based MRD in treatment stratification, patient outcomes improved further. Still 15-20% of patients relapse, and their survival lags behind that achievable according to results of best published studies.
In 2013, a project group specifically dedicated to ALL relapse was established in many ALL-IC countries.
chair: Janez Jazbec, Slovenia
- Dániel Erdélyi, Hungary
- Juan Tordecilla, Chile
- Marko Kavčič, Slovenia
- Monica Makiya, Argentina
- Sophia Polychronopoulou, Greece
- Volkan Hazar, Turkey
The steering committee member belonging to Semmelweis University is dr Dániel Erdélyi, you can contact him via email with questions at email@example.com
The group introduced a unified treatment protocol (ALL-IC REL 2016) addressing first relapse cases. The protocol used the IntReALL 2010 SR and HR study standard arms, with minor changes, as best available practice guidance for ALL-IC countries. As flow-cytometric determination of minimal residual disease was already an integral part of ALL-IC 2002 and 2009 studies and is a technology available, standardised, quality controlled in ALL-IC countries, flow-cytometry is used for assessment of treatment response in this protocol.
As per the knowledge of the steering committee, this guidance is applied in the following countries, either in all or just some of the centres: Argentina (GATLA), Bulgaria, Chile, Croatia, Georgia, Greece, Hungary, Lebanon, North Macedonia, Romania, Serbia, Slovenia, Turkey, Uruguay.
A common registry was also established in REDCap platform. Pseudonimised patient data are entered here with follow up MRD values, toxicity grading and data on outcome.
In 2021, we presented preliminary results at the virtual Childhood Leukemia and Lymphoma Conference (CLLS 2021, 11th– 12th March 2021):(https://semmelweis.hu/gyermekklinika2/files/2022/05/ALL-.IC-REL_e-poster_CLLS-2020-2021_v4.pdf)
Results of a larger cohort with longer follow up and subgroup analyses are being prepared in the format of an original journal article.
The latest 2019 protocol version is available at the following link: https://semmelweis.hu/gyermekklinika2/files/2022/05/ALL-IC-REL-2016_v1.1_2019-09-16.pdf
As of March 2022, a protocol update is being prepared to include new immunotherapy options.
A tumour board with monthly online meetings started in June 2022. All international colleagues are welcome to take part and to present their difficult resistant / relapsed ALL cases for debate. If interested, please contact Dr. Koray Yalcin (firstname.lastname@example.org) and Volkan Hazar (email@example.com) to get access and to get on the mailing list.
The ALL-IC REL study group would welcome further centres or countries to join. The protocol is open for use to anyone. We encourage non-ALL-IC members, too, to use the registry and upload data of patients treated (even just partly) along this protocol. The register is at REDCap, a free secure IT platform, all users can download their own uploaded data any time.
For access to the registry, please email Marko Kavcic at firstname.lastname@example.org