Intensified chemotherapy shows promise for children with very high risk form of leukemia

Young patients with an aggressive form of leukemia who are likely to relapse after chemotherapy treatment can significantly reduce those odds by receiving additional courses of chemotherapy, suggest the findings of a clinical trial led by investigators at Dana-Farber/Children's Hospital Cancer Center in Boston.

The trial leaders will present the results of the Dana-Farber Cancer Institute ALL Consortium study, which involved nearly 500 patients under age 18 with B-precursor (B-ALL), at the annual meeting of the American Society of Hematology (ASH) conference.

Trial participants received an initial course of "induction" for B-ALL, a cancer of the blood that is one of the most common cancers in children below age 15. After a month of treatment, the patients had a bone marrow sample sent for a test able to measure levels of leukemia that cannot be seen under a microscope.

Thirty-five of the patients were deemed to have a very high risk of relapsing because they retained relatively large numbers of as measured by this test. An additional 16 patients were also considered very high-risk because their leukemia cells had certain .

These 51 patients then received an intensified consisting of two additional rounds of chemotherapy using agents not typically given to newly diagnosed patients with B-ALL. This was followed by an intensified consolidation phase of therapy to keep the disease in remission, and then a standard maintenance phase to further deter the disease from returning.

Investigators estimate that, five years after reaching complete remission, the rate of event-free survival (a measure of survival without relapse or development of another cancer) was 76 percent for these very high-. By contrast, less than half of similar patients who receive standard chemotherapy reach the five-year mark without relapsing.

" with B-ALL traditionally receive a standard course of chemotherapy if their risk of relapse is low, and a slightly intensified course if their risk is higher," says the study's lead author, Lynda Vrooman, MD, of Dana-Farber/Children's Hospital Cancer Center. "In this study, we identified a new risk group – those with a very high risk of relapse – and studied the effect of a novel, even more intensive chemotherapy regimen on their outcome."

"Though it involved a relatively small number of patients, the new trial is one of the first to show improved outcomes for this set of as a result of an intensified chemotherapy protocol," says senior author Lewis Silverman, MD, of Dana-Farber/Children's Hospital Cancer Center. Trial leaders will continue to track the study participants to gauge the durability of the remissions produced by the intensified treatment.

add to favorites email to friend print save as pdf

Related Stories

Gene responsible for relapses in young leukemia patients

Oct 26, 2011

One of the causes of resistance to cancer treatment in children is now beginning to be elucidated. Acute lymphoblastic leukemia patients with a particular form of the ATF5 gene are at higher risk of having a relapse when ...

Recommended for you

Immune checkpoint inhibitors may work in brain cancers

Nov 21, 2014

New evidence that immune checkpoint inhibitors may work in glioblastoma and brain metastases was presented today by Dr Anna Sophie Berghoff at the ESMO Symposium on Immuno-Oncology 2014 in Geneva, Switzerland.

New model of follow up for breast cancer patients

Nov 21, 2014

Public health researchers from the University of Adelaide have evaluated international breast cancer guidelines, finding that there is potential to improve surveillance of breast cancer survivors from both a patient and health ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.