Treatment in a backpack

Minimal residual disease (MRD)—small numbers of leukemic cells—is a major cause of relapse in leukemia and lymphoma patients. Patients routinely have their blood and bone marrow examined for signs of MRD.

Studies of pediatric patients with Acute Lymphoblastic Lymphoma (ALL) have revealed incidences of relapse in patients whose MRD results indicated a positive prognosis.

Researchers are exploring techniques to better identify patients who face a higher risk of relapse in order to adjust their course of treatment. One promising technique uses High Throughput Sequencing (HTS)—a technology that examines DNA markers within the disease rather than just the presence of disease.

St. Luke’s Cancer Institute is participating in two studies on HTS technology sponsored by the National Cancer Institute. The NCI studies enlist 217 research centers worldwide, among them Stanford Children’s Health, Yale Children’s Hospital, Children’s National Hospital, and St. Jude Children’s Research Hospital.

A primary objective of the AALL1731 study is to determine whether more aggressive treatment in this pediatric population would decrease the chance of relapse. Patients in the experimental group are treated with an (additional) drug called blinatumomab.

The standard administration of this drug—through continuous IV—requires a 28-day hospital stay. This study is designed for home administration of the drug using a special pump that fits portably in a backpack. Patients need only come to the clinic once per week, allowing patients to maintain a more normal routine.

Rental fees for the backpack pump run $4000 per patient. The Institute does not own the type of pumps required, and patient’s insurance does not cover this research-related expense.

KTM funds cover the cost of these pumps, allowing St. Luke’s to enroll patients in the study whose families could not otherwise afford it.