Evidence map›Paper›PMID 37168381›Full record

ReviewFrontiers in oncology2023

Management of B-cell lineage acute lymphoblastic leukemia: expert opinion from an Indian panel

Vikram Mathews, Anu Korula, Anupam Chakrapani, Dinesh Bhurani, Jina Bhattacharyya, Manju Sengar, Pankaj Malhotra, Pavan Kumar Boyella, Pawan Kumar Singh, Prasanth Ganesan and 5 more

Open access · goldAbstract readReview
In one paragraph

Review in Frontiers in oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 13 institutions in 1 country.

Vikram MathewsDepartment of Haematology, Christian Medical College, Vellore, Tamil Nadu, India.
Anu KorulaDepartment of Haematology, Christian Medical College, Vellore, Tamil Nadu, India.
Anupam ChakrapaniClinical Hematology, Apollo Gleneagles Hospital, Kolkata, India.
Dinesh BhuraniDepartment of Hemato-Oncology & Bone Marrow Transplant (BMT) Unit, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, India.
Jina BhattacharyyaDepartment of Clinical Hematology, Gauhati Medical College and Hospital, Guwahati, Assam, India.
Manju SengarMedical Oncology Department, Tata Memorial Hospital, Mumbai, Maharashtra, India.
Pankaj MalhotraDepartment of Clinical Hematology and Medical Oncology, Nehru Hospital, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
Pavan Kumar BoyellaDepartment of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Centre, Hyderabad, Telangana, India.
Pawan Kumar SinghHaemato-Oncology & Bone Marrow Transplant (BMT), B.L. Kapur (BLK)-Max Center for Bone Marrow Transplant, BLK-Max Superspeciality Hospital, New Delhi, India.
Prasanth GanesanDepartment of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Rishi DhawanClinical Hematology, All India Institute of Medical Sciences, Delhi, India.
Sameer MelinkeriDepartment of Hematology, Deenanath Mangeshkar Hospital & Research Center, Pune, India.
Sharat DamodarMazumdar Shaw Medical Center, Narayana Health City, Bengaluru, Karnataka, India.
Tuphan Kanti DolaiDepartment of Haematology, Nil Ratan Sarkar (NRS) Medical College and Hospital, Kolkata, India.
Venkatraman RadhakrishnanDepartment of Medical Oncology and Pediatric Oncology, Cancer Institute (WIA), Chennai, India.
Christian Medical College, Vellore · INAll India Institute of Medical Sciences · INApollo Gleneagles Hospitals · INBLK Super Speciality Hospital · INCancer Institute (WIA) · INDeenanath Mangeshkar Hospital and Research Center · INGauhati Medical College and Hospital · INJawaharlal Institute of Post Graduate Medical Education and Research · INNarayana Health · INNil Ratan Sircar Medical College and Hospital · INPost Graduate Institute of Medical Education and Research · INRajiv Gandhi Cancer Institute and Research Centre · INTata Memorial Hospital · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Currently, there are no guidelines for the management of B-cell lineage acute lymphoblastic leukemia (B-ALL) from an Indian perspective. The diagnostic workup, monitoring, and treatment of B-ALL vary among different physicians and institutes. Objective: To develop evidence-based practical consensus recommendations for the management of B-ALL in Indian settings. Methods: Modified Delphi consensus methodology was considered to arrive at a consensus. An expert scientific committee of 15 experts from India constituted the panel. Clinically relevant questions belonging to three major domains were drafted for presentation and discussion: (i) diagnosis and risk assignment; (ii) frontline treatment; and (iii) choice of therapy (optimal vs. real-world practice) in relapsed/refractory (R/R) settings. The questionnaire was shared with the panel members through an online survey platform. The level of consensus was categorized into high (≥ 80%), moderate (60%-79%), and no consensus (< 60%). The process involved 2 rounds of discussion and 3 rounds of Delphi survey. The questions that received near or no consensus were discussed during virtual meetings (Delphi rounds 1 and 2). The final draft of the consensus was emailed to the panel for final review. Results: Experts recommended morphologic assessment of peripheral blood or bone marrow, flow cytometric immunophenotyping, and conventional cytogenetic analysis in the initial diagnostic workup. Berlin-Frankfurt-Münster (BFM)-based protocol is the preferred frontline therapy in pediatric and adolescent and young adult patients with B-ALL. BFM/German Multicenter Study Group for Adult Acute Lymphoblastic Leukemia-based regimen is suggested in adult patients with B-ALL. Immunotherapy (blinatumomab or inotuzumab ozogamicin) followed by allogeneic hematopoietic cell transplantation (allo-HCT) is the optimal choice of therapy that would yield the best outcomes if offered in the first salvage in patients with R/R B-ALL. In patients with financial constraints or prior allo-HCT (real-world practice) at first relapse, standard-intensive chemotherapy followed by allo-HCT may be considered. For subsequent relapses, chimeric antigen receptor T-cell therapy or palliative care was suggested as the optimal choice of therapy. Conclusion: This expert consensus will offer guidance to oncologists/clinicians on the management of B-ALL in Indian settings.

Indexed as

B-cell acute lymphoblastic leukemiaconsensusDelphiIndiamanagementrelapsed/refractory

Identifiers

PMID37168381
PMCPMC10166232
OpenAlexW4366828117

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.