Clinical Letter to the EditorFood-dependent exercise-induced anaphylaxis due to potato snacks involving recurring psychogenic abdominal painAkiko Ikedaa, Atsushi Inagakia, Yuki Nishikawaa, Mariko Shimizua, Chiharu Kawaguchia, Nayu Satob,c, Masashi Nakamurab,c, Tomofumi Kawabec, Kayoko Matsunagaba Department of Pediatrics, Yamato-Takada Municipal Hospital, Nara, Japanb Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, Aichi, Japanc General Research and Development Institute, Hoyu Co., Ltd., Aichi, JapanRunning title: FDEIA from potato snacks

Background. Measurable residual disease (MRD) is a powerful prognostic factor in patients with acute myelogenous leukemia (AML). We previously conducted a prospective study on an MRD-based strategy for the treatment of children with AML, and its significance has been reported. The present retrospective study is a pooled analysis of 34 patients who were registered after the completion of the previous study. Procedure. Reduced-intensity conditioning (RIC) followed by allogeneic hematopoietic stem cell transplantation (RIC-HSCT) was adopted to increase survival rates and minimize toxicities. The strategy was also refined with a minor modification, with WT1 expression levels in peripheral blood, as an MRD marker after a 2nd course of chemotherapy (consolidation course 1), being measured in addition to WT1, chimeric mRNA, and aberrant surface markers in bone marrow. Results. Five-year relapse-free and overall survival rates were 76.5 and 85.2%, respectively. RIC-HSCT was safely and effectively performed on MRD-positive patients. Among patients who underwent RIC-HSCT, re-emerging/rising MRD and high levels of MRD before HSCT were risk factors for disease relapse early after HSCT. Conclusions. The MRD-based strategy and RIC-HSCT worked well for children with AML. HLA-haploidentical peripheral blood transplantation following RIC may be a promising candidate for further study on patients at very high risk of relapse.