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Acute lymphoblastic leukemia (ALL)

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B-ALL

Know where you stand

Acute lymphoblastic leukemia (ALL) is a very aggressive cancer of the bone marrow caused by overproduction of underdeveloped B cells. This slows production of normal healthy cells, leading to symptoms such as anemia (due to low red blood cell count) and frequent infections (due to low white blood cell count).1

New therapies are helping more patients get well and stay well—especially children—but this cancer can get worse quickly.2,3 If you know that any residual disease is present, you and your doctor can take immediate action. It may be important to be sure of your exact MRD status at key points in your care or your child’s care.

clonoSEQ patient brochure

B-ALL in children

When should you monitor with clonoSEQ®?

There are several stages of treatment for pediatric B-ALL. Your child’s doctor may want to monitor MRD after each type of treatment, to see how effective it was. Your child’s MRD test results with clonoSEQ may guide the choice of which treatment comes next. For example:

1

Initial diagnosis4

Identify cancer cell DNA (Clonality ID Test)

This clonoSEQ test provides a baseline. Because this test will have the largest number of cancer cells, it helps clonoSEQ know which cells to track over time in subsequent MRD tests.

2
After induction therapy4

This first part of your child’s treatment usually includes chemotherapy and corticosteroids. MRD results can guide your child’s doctor in deciding how strong the next stage of treatment should be.

MRD testing with clonoSEQ
3
After consolidation therapy4

This course of chemotherapy helps make your child’s previous chemotherapy treatment work better. MRD results can help your child’s doctor decide whether a stem cell transplant is needed.

MRD testing with clonoSEQ
4
After stem cell transplant5

Sometimes a stem cell transplant is helpful. Healthy stem cells replace the stem cells in your child’s bone marrow that the chemotherapy destroyed.

MRD testing with clonoSEQ
5
During maintenance therapy and beyond4

A low dose of a targeted therapy given over a long period of time may help prevent your child’s cancer from coming back.

Your doctor may want to continue frequently monitoring MRD status with clonoSEQ. Your child’s MRD status can help you and your doctor feel secure, knowing that if your child’s B-ALL returns, you can treat it immediately.

MRD testing with clonoSEQ

clonoSEQ in action:
A case study

Let’s look at how clonoSEQ helped a young B-ALL patient.

Remember, this is only 1 example—and clonoSEQ has helped children with many different B-ALL profiles.

This is for illustration purposes only. The actual clonoSEQ report will look different as shown here.

  • The patient: A pre-adolescent boy
  • The goal: For no detectable MRD to be present
  • The treatment: Induction therapy, stem cell transplant

One year after transplant, the boy was MRD-negative. They continued to test for MRD every 3 months to monitor for any potential changes.

B-ALL in adults

When should you monitor with clonoSEQ?

There are several stages of treatment for B-ALL. Your doctor may want to check after each one, to see how effective it was. Your MRD test results with clonoSEQ may guide which treatment comes next.6-12 For example:

1

Initial diagnosis6

Identify cancer cell DNA (Clonality ID Test)

This clonoSEQ test provides a baseline. Because this test will have the largest number of cancer cells, it helps clonoSEQ know which cells to look for in later tests.

2
After induction therapy6

This first part of your treatment usually includes chemotherapy and corticosteroids. MRD results can help your doctor decide whether a stem cell transplant is needed.

MRD testing with clonoSEQ
3
After consolidation therapy6

This course of chemotherapy helps make your previous chemotherapy treatment work better. Your doctor may choose to measure MRD after consolidation.

MRD testing with clonoSEQ
4
After stem cell transplant5

If MRD is still present, a stem cell transplant may be helpful. Healthy stem cells replace the stem cells in your bone marrow that the chemotherapy destroyed.

MRD testing with clonoSEQ
5
During maintenance therapy and beyond6

Your doctor may decide to use a low dose of a targeted therapy given over a long period of time to help prevent your cancer from coming back.

Your doctor may want to continue frequently monitoring MRD status with clonoSEQ, whether or not you are on maintenance therapy. Your MRD status can help you and your doctor feel secure, knowing that if your B-ALL returns, you can treat it immediately.

MRD testing with clonoSEQ

clonoSEQ in action:
A case study

Let’s look at how clonoSEQ helped a patient like you.

Remember, this is only 1 example—and clonoSEQ has helped people with many different B-ALL profiles.

This is for illustration purposes only. The actual clonoSEQ report will look different as shown here.

  • The patient: This patient was eligible for transplant
  • The goal: No detectable MRD after consolidation therapy and able to receive a stem cell transplant

Once the patient showed no trace of MRD, he and his doctor decided to continue testing with clonoSEQ every 6 months to monitor his MRD status.

If you or your child have B-ALL, talk with your doctor about clonoSEQ. Pinpoint where you are—and come up with a plan that works for you.

Questions to ask your doctor


This page is intended for a US-based audience.

clonoSEQ® is an FDA-cleared test used to detect minimal residual disease (MRD) in bone marrow from patients with multiple myeloma or B-cell acute lymphoblastic leukemia (B-ALL) and blood or bone marrow from patients with chronic lymphocytic leukemia (CLL). clonoSEQ is also available for use in other lymphoid cancers and specimen types as a CLIA-validated laboratory developed test (LDT).

clonoSEQ is only available by prescription from a licensed healthcare professional. Results may vary. Talk to your healthcare provider to see if clonoSEQ testing is right for you. For important information about the FDA-cleared uses of clonoSEQ including test limitations, please visit clonoSEQ.com/technical-summary.

References

  • Acute lymphoblastic leukemia. NCCN Guidelines®. Accessed November 9, 2021. https://www.NCCN.org/patientresources/patient-resources/guidelines-for-patients
  • Hunger S, Mullighan C. N Engl J Med. 2015;373(16):15‌41-15‌52.
  • Sive J, et al. Br J Haematol. 2012;157(4):463-471.
  • Referenced with permission from the NCCN Clinical Practice Guidelines (NCCN Guidelines®) for Pediatric Acute Lymphoblasic Leukemia V.2.2021. © National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed October 19, 2021. 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.
  • Pulsipher M, et al. Blood. 2015;125(22):35‌01-35‌08.
  • Referenced with permission from the NCCN Clinical Practice Guidelines (NCCN Guidelines®) for Acute Lymphoblasic Leukemia V.2.2021. © National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed October 19, 2021. 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.
  • Brüggemann M, et al. Blood. 2006;107(3):11‌16-11‌23.
  • Raff T, et al. Blood. 2007;109(3):910-915.
  • Vidriales M, et al. Blood. 2003;101(12):46‌95-47‌00.
  • Patel B, et al. Br J Haematol. 2010;148(1):80-89.
  • Pemmaraju N, et al. Am J Hematol. 2017;92(3):279-285.
  • Bassan R, et al. Blood. 2009;113(18):41‌53-41‌62.