Dr Sarah Tasian: NGS Has Revolutionized Treating Children With AML

The advent of next-generation sequencing has meant better care for children with acute myeloid leukemia (AML), a better understanding of rare subtypes of genetic AML, and a better prognosis for these patients, said Sarah Tasian, MD, attending physician in the Division of Oncology at Children’s Hospital of Philadelphia.

Transcript

How is genetic testing being used in pediatric tumors?

Genetic testing is critical. I think the evolution of affordable and rapid turnaround time with next-generation sequencing has revolutionized our care of children with AML. We now know so much more about very rare subtypes of genetic AML and children. We have done a lot of work retrospectively through the Children's Oncology Group, as well as our collaborators and some of the European pediatric oncology consortia to really understand, you know, what the relapse risk with the overall survival is of some children who have extremely, sometimes cytogenetically cryptic molecular features.

So, we now know there are probably 40 different types of childhood AML with respect to genetic stratification, and now that we are a little bit able better able to understand what the prognosis is of some of these, I think it's really helping us to understand who our highest risk patients are. We will, in our upcoming trials, start transplanting more patients in first remission based on genetics that we didn't previously know about. And I think it's also going to help us to identify patients in particular who may be best suited for immunotherapies later, that we know from the get-go, the time that they're diagnosed, that they are at very high risk of relapse. And we don't always know that transplant improves overall survival for some of these children.

And so, I think genetic testing will really help us to implement any of the therapy application better.