Identification of residual disease followed by trade-off analysis between drug optimisation, MRD and sustenance of normal haematopoiesis under maintenance chemotherapy in childhood ALL Online publication date: Thu, 01-Jun-2023
by Durjoy Majumder
International Journal of Modelling, Identification and Control (IJMIC), Vol. 42, No. 4, 2023
Abstract: ALL, an acute lymphoblastic leukaemia commonly occurring cancer in children, relapses in many cases. Hence to remove (minimal) residual leukaemia or disease (MRD), a maintenance chemotherapy schedule is conducted for two years after intensive chemotherapy. MRD detection occasionally fails due to mutability behaviour of leukemic cells or their aberrant marker expression and presence of MRD in very minor amount enhances the chances of disease relapse in long-term. Application of higher drug dose during maintenance phase could remove MRD but produces drug related toxicity. Bone marrow biopsy is required for MRD detection. Here, a peripheral blood-based control theoretic model is proposed to detect the presence of MRD. Moreover, the model-based eigenvalue and trade-off analysis could provide a guidance in clinical decision making to optimise the maintenance chemotherapeutic regime (both dose and duration) for individual ALL patients.
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