Delighted to present at ASH: Three updates on the FORUM trial
(Vienna, 12.12.2022) Prof. Christina Peters, MD, from St. Anna Children’s Hospital and St. Anna CCRI presents new data showing a dire need for immunotherapy strategies tackling high-risk childhood leukemia at the Annual Meeting of the American Society of Hematology (ASH). Other updates from the same study (FORUM) confirm the superiority of total body irradiation prior to stem cell transplantation and the use of transplants from matched unrelated donors in children under the age of four with high-risk acute lymphoblastic leukemia (ALL).
New results from the prospective FORUM study including 194 patients revealed that, infants and young children with high-risk-ALL receiving hematopoietic stem cell transplantation after preparative chemotherapy generally have a worse chance of survival than children above the age of four. In particular, a genetic aberration in leukemia cells termed “KMT2A-rearrangement”, which was present in 53 patients, negatively affected survival outcome. However, mortality not associated with relapses was lower in this analysis compared to previously reported series, representing an improvement. “Considering these results, we urgently need pre- and post-transplant immunotherapeutic strategies to reduce relapses without increasing chemotherapy-associated complications”, Christina Peters points out. ((Peters et al., Abstract 370, https://ash.confex.com/ash/2022/webprogram/Paper168609.html)
Another analysis from the FORUM trial, presented by Jean-Hugues Dalle from Robert Debré Hospital (Paris), shows a better outcome for children with high-risk ALL receiving stem cell transplants from matched unrelated donors compared to matched siblings. The overall survival after three years was significantly better in the matched unrelated donor group (p=0,041). The cumulative incidence of acute graft-versus-host-disease was comparable in both groups, but the 3-year-cumulative incidence of chronic graft-versus-host-disease was higher in matched sibling donors (p=0,07).
“The greater immune-genetic disparity in the matched unrelated donor/recipient pairs protects from the risk of disease recurrence, while the use of serotherapy the occurrence of chronic Graft-versus-Host-Disease”, concludes Jean-Hugues Dalle. (Dalle et al., Abstract 372, https://ash.confex.com/ash/2022/webprogram/Paper164735.html)
Franco Locatelli from Ospedale Pediatrico Bambino Gesù (Rome) presents an update confirming the FORUM study results after long-term follow-up: The use of total body irradiation combined with etoposide prior to stem cell transplantation is associated with better outcomes in children with high-risk ALL than the use of chemotherapy based conditioning. The improved survival results with total body irradiation are mainly due to decreased risk of leukemia recurrence. (Locatelli et al., Poster Abstract 2122, https://ash.confex.com/ash/2022/webprogram/Paper166048.html)
The Annual Meeting of the American Society of Hematology is the world’s largest hematology-oncology conference with more than 15,000 attendees. This year it is held in New Orleans from Dec. 10 to 13. >> https://www.hematology.org/meetings/annual-meeting
FORUM trial >> https://ascopubs.org/doi/full/10.1200/JCO.20.02529
Frontiers in Pediatrics Research Topic on Allogeneic Hematopoietic Stem Cell Transplantation for Children with Acute Lymphoblastic Leukemia in the Era of Immunotherapy >> https://bit.ly/3TBCpoT