Dr Hisham Abdel-Azim speaks to ecancer about high event-free (EFS) and overall survival (OS) after non-total body irradiation (TBI) conditioning and allogeneic haematopoietic cell transplantation (HCT) in next-generation-sequencing minimal residual disease (NGS-MRD) negative B-acute lymphoblastic leukaemia (B-ALL): Results from the EndRAD trial (PTCTC ONC1701.

This trial evaluated whether children, adolescents, and young adults (CAYA) with high-risk/relapsed B-ALL who were MRD-negative by next-generation sequencing before transplant could safely receive myeloablative non-TBI conditioning. 

Among 51 patients across 45 centers, the study achieved a 2-year event-free survival of 76% and overall survival of 82%, with low early transplant-related mortality (2%) and acceptable GVHD rates. 

Dr Abdel-Azim concludes that these results suggest that MRD-guided selection of non-TBI regimens may provide outcomes comparable to TBI while potentially reducing long-term toxicities, supporting a strategy to limit radiation exposure in eligible CAYA B-ALL patients.