Beyond Standard Protocols: Real-world Challenges and Innovative Solutions in Pediatric Leukemia Management - “Experience from a Tertiary Oncology Center Integrating MRD-guided Therapy and Novel Agents”

Shweta Pathak; Dr. Chesta Jain; Dr. Vidya Kumari Saurav; Dr.Monica Lazarus; Dr. Kavya; Dr. Palash; Dr. Lalita Singh

doi:10.36948/ijfmr.2025.v07i03.48493

Beyond Standard Protocols: Real-world Challenges and Innovative Solutions in Pediatric Leukemia Management - “Experience from a Tertiary Oncology Center Integrating MRD-guided Therapy and Novel Agents”

Author(s)	Dr. Shweta Pathak, Dr. Chesta Jain, Dr. Vidya Kumari Saurav, Dr.Monica Lazarus, Dr. Kavya, Dr. Palash, Dr. Lalita Singh
Country	India
Abstract	Background: Pediatric acute leukemias represent a heterogeneous group of malignancies with variable prognoses. Although survival rates have improved significantly with risk-adapted protocols and advances in supportive care, management becomes complicated in the presence of comorbidity, age-related challenges, or rare molecular subtypes. Objective: To present three pediatric cases—infantile AML, ALL in a child with Down syndrome, and APML with differentiation syndrome—demonstrating diagnostic dilemmas, therapeutic challenges, and the potential of modified regimens. Methods: Retrospective descriptive case series at a tertiary pediatric oncology unit, examining clinical profiles, treatment adaptations, and outcomes. Results: All patients achieved remission. Two required significant modifications due to toxicity or preexisting conditions. Integration of MRD-guided strategies, novel therapeutic agents like azacitidine and venetoclax, and aggressive management of complications led to favorable outcomes. Conclusion: Personalized protocols, vigilant monitoring, and early recognition of complications are essential in pediatric leukemia care. Incorporation of newer agents may rescue patients where traditional therapies fail or are poorly tolerated.
Keywords	Pediatric Leukemia, Personalized Therapy, Novel Agents
Field	Medical / Pharmacy
Published In	Volume 7, Issue 3, May-June 2025
Published On	2025-06-19
DOI	https://doi.org/10.36948/ijfmr.2025.v07i03.48493

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Beyond Standard Protocols: Real-world Challenges and Innovative Solutions in Pediatric Leukemia Management - “Experience from a Tertiary Oncology Center Integrating MRD-guided Therapy and Novel Agents”

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