Acute Lymphocytic Leukemia

P4, N=44, Completed, Pfizer | Active, not recruiting --> Completed

CD24 therefore emerged as an effective target in BCP-ALL, and the combination of CD24 and CD123 as a potential effective double-targeting strategy. The combination of different recognition modalities (eg, a CAR and CD16) should be tested to determine whether it provides synergistic cytotoxic activity in triple targeting.

The overall evidence supports the continued promotion of adequate maternal folate intake. Future research should prioritize causal inference methods, epigenome-wide analyses, and greater inclusion of underrepresented populations to clarify the role of folate in childhood cancer etiology.

P=N/A, N=84, Completed, Istituto Romagnolo per lo Studio dei Tumori Dino Amadori IRST S.r.l. IRCCS | Recruiting --> Completed | N=120 --> 84

Patients ≥60 years with Ph-negative B-cell ALL and TP53 VAF ≥45% had poor outcomes, with 4-year event-free survival (EFS) and overall survival (OS) of 28%, driven primarily by increased relapse risk, even among patients treated with frontline inotuzumab ozogamicin (INO) and/or blinatumomab. TP53 persistence at remission occurred in 44% of tested patients and was associated with increased ALL relapse risk. These results demonstrate that TP53 VAF is prognostic in older patients with Ph-negative B-cell ALL; high VAF may increase relapse risk but is not independently associated with survival in younger patients.

It highlights an unusual and serious pattern of relapse in an extramedullary site following blinatumomab therapy. Clinicians should remain vigilant for signs of lineage switch and extramedullary disease during treatment, particularly in patients with KMT2A-rearranged B-ALL, and consider imaging or biopsy when new neurologic or systemic symptoms arise.

Importantly, we identified novel single nucleotide variants in DUX4, CSF3R and CREBBP, and fusion transcripts. This study not only reports transcriptional heterogeneity in our Latin American cohort but also supports the implementation of open-source bioinformatic pipelines in resource-limited settings to enhance precision diagnosis and guide personalized treatment.

P1/2, N=32, Active, not recruiting, Bambino Gesù Hospital and Research Institute | Recruiting --> Active, not recruiting | Trial primary completion date: Mar 2025 --> Mar 2027

Our results support a dual approach: HSCT for patients with high-risk cytogenetics or MRD positivity, and MRD-guided therapy for those not eligible for transplant. These findings reinforce risk-adapted strategies and lay the groundwork for future trials combining genetic and MRD-guided management in Ph- B-ALL.

P=N/A, N=45, Recruiting, Hospital General de Mexico

P1, N=16, Active, not recruiting, Dana-Farber Cancer Institute | Trial completion date: Dec 2025 --> Jun 2026

P2, N=80, Recruiting, Children's Oncology Group | Trial completion date: Mar 2026 --> Dec 2026 | Trial primary completion date: Mar 2026 --> Dec 2026