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

December 10, 2012

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.

Explore further: Chemotherapy proves life-saving for some leukemia patients who fail induction therapy

Related Stories

Chemotherapy proves life-saving for some leukemia patients who fail induction therapy

April 11, 2012
An international study found that bone marrow transplants are not the best option for some young patients with acute lymphoblastic leukemia (ALL) who fail to attain clinical remission after the initial weeks of intense chemotherapy ...

Reduced intensity regimen prior to marrow transplant better for older leukemia patients

December 10, 2012
A new study led by researchers at the Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) shows that preparing older acute myeloid ...

Experimental graft-vs.-host disease treatment equivalent to standard care in Phase 3 trial

December 10, 2012
An experimental drug combination for preventing graft-versus-host disease (GVHD) was not significantly better than the standard regimen on key endpoints, according to a report of a phase 3 trial at the American Society of ...

Gene responsible for relapses in young leukemia patients

October 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

Anti-cancer chemotherapeutic agent inhibits glioblastoma growth and radiation resistance

July 24, 2017
Glioblastoma is a primary brain tumor with dismal survival rates, even after treatment with surgery, chemotherapy and radiation. A small subpopulation of tumor cells—glioma stem cells—is responsible for glioblastoma's ...

New therapeutic approach for difficult-to-treat subtype of ovarian cancer identified

July 24, 2017
A potential new therapeutic strategy for a difficult-to-treat form of ovarian cancer has been discovered by Wistar scientists. The findings were published online in Nature Cell Biology.

Immune cells the missing ingredient in new bladder cancer treatment

July 24, 2017
New research offers a possible explanation for why a new type of cancer treatment hasn't been working as expected against bladder cancer.

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

0 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.