The following hypothetical case studies may be similar to patients who present in your practice. Explore below to learn more.

case study lauren

Meet Lauren

A female patient with Ph(–) B-cell precursor ALL who achieved CR and subsequently tested MRD(–)

A female patient with Ph(–) B-cell precursor ALL who achieved CR and subsequently tested MRD(–)

MRD snapshot

nccn guidelines

nccn guidelines
Diagnosis

35% peripheral blasts

End of Induction

< 0.01% blasts

Surveillance

Ongoing

Name: Lauren K.

Age: 47

Sex: Female

Diagnosis: Ph(–) B-cell precursor ALL

Cytogenetics: Hyperdiploidy (> 50 chromosomes)

Considering you’ve received an MRD(–) result after CR, what may be your approach to monitoring this patient and evaluating the next course of treatment?

answer choices

Evaluate the patient for signs and symptoms of relapse at their scheduled appointments

answer choices

Monitor the patient by testing for MRD every 3–6 months

case study mateo

Meet Mateo

A male patient with Ph(+) B-cell precursor ALL who tested MRD(+) after frontline treatment

A male patient with Ph(+) B-cell precursor ALL who tested MRD(+) after frontline treatment

MRD snapshot

nccn guidelines

nccn guidelines
Diagnosis

55% peripheral blasts

End of Induction

0.15% blasts

Surveillance

Name: Mateo R.

Age: 74

Sex: Male

Diagnosis: Ph(+) B-cell precursor ALL

Cytogenetics: t(9;22) BCR-ABL

After this patient tested MRD(+) following frontline treatment, what would your next steps be?

answer choice

Rechallenge with
chemotherapy

answer choice

Consider alternative
treatment options

ALL, acute lymphoblastic leukemia; CR, complete response; MRD, measurable residual disease; Ph(–), Philadelphia chromosome–negative; Ph(+), Philadelphia chromosome–positive.

References: 1. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Acute Lymphoblastic Leukemia v.2.2019. ©National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed October 16, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. 2. Berry DA, Zhou S, Higley H, et al. Association of minimal residual disease with clinical outcome in pediatric and adult acute lymphoblastic leukemia: a meta-analysis. JAMA Oncol. 2017;3:e170580.

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