International Leukemia Target Board (iLTB): Advancing Care for Relapsed and Refractory Leukemia/Lymphoma Patients

The international Leukemia Target Board (iLTB) is a registry and platform for documenting and discussing treatment options for children, adolescents, and young adults with relapsed and refractory leukemia/lymphoma. Launched to support molecular, protein, and drug response profiling, iLTB unites an international team of experts to enhance therapeutic decision-making for this vulnerable patient group.

Patients with relapsed and refractory leukemia/lymphoma face a grim prognosis due to the lack of effective salvage therapies. Challenges include relapse after CAR-T cell therapy in B-cell precursor acute lymphoblastic leukemia (BCP-ALL) and persistent MRD after reinduction therapy for relapsed T-cell ALL (T-ALL). Despite molecular profiling efforts in many European countries, the diversity and rarity of actionable events across different disease types present significant barriers to improved outcomes.

iLTB provides a platform for international collaboration among pre-clinical, biological, medical, and clinical trial experts to harmonize treatment decisions for complex cases. By facilitating discussion of national profiling results at a European level, the iLTB generates prioritized treatment advice for pediatric patients. The accompanying registry captures data on patient numbers, actionable event frequencies, trial eligibility, and reasons for non-referral to clinical trials. This effort aims to enhance patient care, expedite drug development, and provide insights into the nature of relapses.

The iLTB seeks to improve outcomes for relapsed and refractory hematological malignancies by prioritizing actionable lesions. Through a standardized approach, the international panel provides treating physicians with guidance on suitable clinical trials or alternative treatments when trial access is not feasible.

The Princess Maxima Center for Pediatric Oncology in Utrecht, Netherlands, sponsors the iLTB study. In Belgium, coordination is managed by the University Hospital of Ghent, with Prof. Dr. Barbara De Moerloose serving as the national coordinating investigator. All Belgian pediatric hematology-oncology centers participate, with a recruitment target of 3 patients annually over 6 years.

This registry is open in Belgium thanks to the financial support of the KinderKankerFonds.