Title: Identification of residual disease followed by trade-off analysis between drug optimisation, MRD and sustenance of normal haematopoiesis under maintenance chemotherapy in childhood ALL
Authors: Durjoy Majumder
Addresses: Department of Physiology, West Bengal State University, Barasat, North 24 Parganas, Kolkata 700 126, India
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.
Keywords: delay ordinary difference equation; drug application control; drug optimisation; chemotherapy in leukaemia; clinical decision support system.
International Journal of Modelling, Identification and Control, 2023 Vol.42 No.4, pp.360 - 374
Received: 02 Mar 2022
Received in revised form: 19 Jun 2022
Accepted: 11 Jul 2022
Published online: 01 Jun 2023 *