The Dutch Childhood Oncology Group ALL10 Protocol for managing acute lymphoblastic leukemia (ALL) has improved the outcome in children by stratifying them and optimizing therapy based on the risk level of the disease. However, IKZF1del ALL patients still have about a three-fold increased relapse risk. Now, researchers have developed the ALL11 protocol by reducing the maximum cumulative dose of anthracyclines from 300 to 240 mg/m 2 for ALL patients and increasing the maintenance therapy duration from two to three years with the administration of methotrexate and 6-mercaptopurine for IKZF1del ALL patients. The study on 819 ALL patients aged one to 18 years showed an improved overall survival (OS; 94.2% vs.
91.9%) and cumulative risk of relapse (CIR; 8.1% vs. 8.4%) when the patients received ALL11 therapy compared to the ALL10 protocol. In addition, the prolonged maintenance therapy…
