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Researchers from Newcastle University and Great Ormond Street Hospital have identified new predictors of relapse in children and young people with acute lymphoblastic leukemia (ALL) treated with the immunotherapy drug blinatumomab, as part of a U.K.-wide study.

Their findings challenge long-standing assumptions based on traditional chemotherapy treatments and could help doctors tailor treatment more precisely to individual patients.

Published in Blood Advances, the study is the first comprehensive analysis of relapse risk factors in children receiving blinatumomab as a replacement for parts of standard chemotherapy.

The findings suggest a more targeted approach could spare some children unnecessary chemotherapy while maintaining excellent outcomes and have already led to revisions of national U.K. treatment guidelines.

Anthony Moorman, joint lead author from Newcastle University, said, "Blinatumomab is transforming the treatment of childhood acute lymphoblastic leukemia, but until now we did not know whether the risk factors used for decades in chemotherapy-based treatment still applied.

"Our findings show that many of them do not. Instead, a child's early response to blinatumomab, together with specific genetic features of their leukemia, provides a much more accurate picture of relapse risk.

"This research will help clinicians identify which patients are likely to do exceptionally well with reduced chemotherapy and which will require a different treatment approach.

"Reducing exposure to chemotherapy has the potential to lessen side effects and improve quality of life, while ensuring that higher-risk patients receive the treatment they need."

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