78. Financially stratified diagnostic, prognostic and treatment response evaluation of ALL in LMIC

Aly Abdelkareem

Sachin Jadhav

Group Head

Hematology and Bone Marrow Transplant

HCG Group of Hospitals


Sachin Jadhava, Yesheswini Naika, Sandeep Raob

aHealthCare Global, Bengaluru, Karnataka, India; bTriesta Labs, Bengaluru, Karnataka, India

Introduction: The prognosis for hematologic malignancies such as acute lymphoblastic leukemia has remarkably improved in the past decade. However, the financial burden of the ever-evolving evaluation and treatment guidelines is a source of strain for patients and caregivers in LMICs, who have limited insurance cover and thus, largely bear this burden with out-of-pocket expenses while also suffering loss of productivity, due to work absenteeism. In addition to this, the incremental improvement in clinical outcomes, vis-a-vis the financial toxicity of diagnostic and prognostic testing, has not been studied in a prospective manner, in a real-life setting.

The Cancer Ground Shot Project, for the treatment of hematologic malignancies, aims to tailor the diagnostic and prognostic evaluation as well as the treatment of patients, based on their socioeconomic profile.

Aim: Create a practical schema for financially-stratified laboratory testing of adult and pediatric ALL (APALL) patients, which integrates state-of-the-art cancer genomics in to an algorithm which will be clinically and socioeconomically relevant for LMICs.

Methods: The first CGS trial, CGS-ALL/01-23, for the treatment of APALL, will be a prospective, three-arm study, where patients will be stratified in 3 levels based on their financial affordability, level 1 (fully dependent on free treatment), level 2 (able to partially bear the cost of treatment) and level 3 (able to bear the full cost of treatment). These would be further sub-categorized as per the current disease risk stratification guidelines.

Conclusion: Clinically and socioeconomically relevant laboratory testing of APALL, which will integrate state-of-the-art cancer genomics, will be presented.