Table 1.

Risk stratification schemes for first relapse

Risk statusDefinition
COG, North America17  
 Low Late B-ALL marrow, end-block 1 MRD < 0.1%
Late IEM, end-block 1 MRD < 0.1% 
 Intermediate Late B-ALL marrow, end-block 1 MRD ≥ 0.1%
Late IEM, end-block 1 MRD ≥ 0.1% 
 High Early B-ALL marrow 
 Early IEM 
 T-ALL relapse, any site and timing 
BFM Group, Western Europe14  
 Low (S1) Late IEM relapses 
 Intermediate (S2) Very early and early IEM relapses
Late B-ALL isolated marrow relapses
Early/late B-ALL combined relapses 
 High (S3 and S4) Very early and early B-ALL marrow relapses 
 Very early B-ALL combined relapses 
 T-ALL marrow relapses (regardless of timing) 
Cancer Research UK Children’s Cancer Group, United Kingdom15  
 Standard Late IEM relapse 
 Intermediate Early IEM relapse
Late isolated B-ALL marrow relapse
Early/late combined B-ALL marrow relapse 
 High Very early IEM relapse 
 B-ALL early isolated marrow elapse 
 B-ALL very-early marrow or combined relapse 
 T-ALL marrow or combined relapse, any timing 
Risk statusDefinition
COG, North America17  
 Low Late B-ALL marrow, end-block 1 MRD < 0.1%
Late IEM, end-block 1 MRD < 0.1% 
 Intermediate Late B-ALL marrow, end-block 1 MRD ≥ 0.1%
Late IEM, end-block 1 MRD ≥ 0.1% 
 High Early B-ALL marrow 
 Early IEM 
 T-ALL relapse, any site and timing 
BFM Group, Western Europe14  
 Low (S1) Late IEM relapses 
 Intermediate (S2) Very early and early IEM relapses
Late B-ALL isolated marrow relapses
Early/late B-ALL combined relapses 
 High (S3 and S4) Very early and early B-ALL marrow relapses 
 Very early B-ALL combined relapses 
 T-ALL marrow relapses (regardless of timing) 
Cancer Research UK Children’s Cancer Group, United Kingdom15  
 Standard Late IEM relapse 
 Intermediate Early IEM relapse
Late isolated B-ALL marrow relapse
Early/late combined B-ALL marrow relapse 
 High Very early IEM relapse 
 B-ALL early isolated marrow elapse 
 B-ALL very-early marrow or combined relapse 
 T-ALL marrow or combined relapse, any timing 

COG definitions: IEM relapse (<18 mo from diagnosis), late IEM (≥18 mo from diagnosis); early marrow relapse (<36 mo from diagnosis), and late marrow relapse (≥36 mo from diagnosis).

BFM and UK definitions: very early (<18 mo from diagnosis), early (18 mo from diagnosis but <6 mo after completion of treatment), and late (≥6 mo after completion of treatment).

IEM, early isolated extramedullary.

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