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

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 known as induction therapy.

The largest study ever of such pediatric ALL patients identified a subset of young children who achieved 10-year survival rates of 72 percent after additional chemotherapy rather than bone marrow transplantation. The patients are among the estimated 85 percent of children with ALL whose cancer begins in white blood cells destined to become B cells.

The results appear in the April 12 edition of the New England Journal of Medicine. The study involved researchers from 14 research groups in the U.S., Europe and Asia.

"Induction failure is a rare event, affecting just 2 to 3 percent of all pediatric ALL patients. But these children are at very high risk for a bad outcome and were always considered candidates for bone marrow transplantation," said Ching-Hon Pui, M.D., chair of the St. Jude Children's Research Hospital Department of Oncology. "These results tell us that induction failure should no longer be considered an automatic indication for a transplant." Pui is the study's corresponding author.

Improvements in both chemotherapy and transplantation prompted investigators to revisit the question of optimal care for these patients. But no single institution or nation had enough patients to answer it. "This study shows the importance of international collaboration to advance the treatment outcome for these patients," said first author Martin Schrappe, M.D., University Medical Center Schleswig-Holstein, Kiel, Germany.

Investigators evaluated the outcomes of 44,017 ALL patients age 17 and younger whose cancer was discovered during a 15-year period ending in December 2000. Each was treated on a clinical trial at one of the centers participating in this international collaborative analysis. St. Jude patients were part of the study. Researchers tracked 1,041 patients whose cancer did not go into remission following four to six weeks of induction therapy.

Historically, the prognosis has been grim for patients who fail induction therapy. While overall long-term survival for childhood ALL patients climbed to 80 percent during the 15 years covered in this study, it was just 32 percent for patients who did not enter remission after the first intense weeks of treatment. The definition of induction failure differed slightly among the clinical trials included in this analysis.

The study found long-term survival rates of 72 percent among some young patients with B-lineage ALL treated with additional chemotherapy following induction therapy failure. The patients were ages 1 through 5 when their cancer was found and many had more than 50 chromosomes in their leukemia cells, rather than the normal number of 46 chromosomes. Together they accounted for about 25 percent of patients whose disease did not go into remission following induction therapy.

The children who benefited from additional chemotherapy also had no other markers of high risk, including high white blood cell counts or chromosomal rearrangements involving the MLL gene.

The study found transplants remain the best hope for many other young ALL patients who fail induction therapy. The patients included those whose cancer originated in white blood cells known as T cells. T cell ALL accounts for 12 to 15 percent of childhood ALL, but about 38 percent of patients in this study. The transplants involve killing the patient's own diseased bone marrow and replacing it with blood-producing stem cells from a genetically matched donor. The procedure leaves patients at risk for a variety of immediate and chronic health problems.

Patients with a chromosomal rearrangement known as the Philadelphia chromosome were not included in the analysis because new drugs have led to a dramatic improvement in their outcome. About 13 percent of ALL induction treatment failures involved patients with the genetic alteration.

Contact: Summer Freeman
St. Jude Children's Research Hospital

Related medicine news :

1. New developments in nanotechnology tackle the 2 biggest problems associated with chemotherapy
2. Roche/Genentech/Chugais Herceptin as an Add-On to Standard Chemotherapy Will Become Decision Resources Clinical Gold Standard in 2013 for the Treatment Of Gastric Cancer
3. Scientists identify microRNA as possible cause of chemotherapy resistance
4. Study evaluates costs and benefits of new chemotherapy drugs
5. Researchers find new chemotherapy combination shows promise in endometrial cancer
6. Chemotherapy plus synthetic compound provides potent anti-tumor effect in pancreatic cancers
7. Recommended Dental Care for Chemotherapy Patients -- Advice from Steven McConnell, DDS
8. Pregnant women can receive breast cancer chemotherapy without endangering health of their babies
9. Making Your Way Through the Fog of Chemotherapy
10. Interruption of Menstrual Cycle by Chemotherapy Associated with Improved Survival in Early Breast Cancer
11. Ancient Chinese herbal recipe eases side effects of chemotherapy
Post Your Comments:
(Date:12/1/2015)... Tampa, FL (PRWEB) , ... December 01, 2015 , ... Florida Hospital Tampa ... the treatment of obesity in the state of Florida. , vBloc® Therapy is a vagal ... age of 18 years with a body mass index (BMI) of at least 40 to ...
(Date:12/1/2015)... ... December 01, 2015 , ... Califia Farms , one of the ... bottle has won top honors in Beverage World Magazine’s Global Packaging Design Awards, taking ... it has been selected as a 2015 U.S.A. Taste Champion in the American Masters ...
(Date:12/1/2015)... ... December 01, 2015 , ... December ... the expansion of the company’s growing product line of food safety and seafood ... and Sockeye (Oncorhynchus nerka) – allow InstantLabs to offer fast, reliable species identification ...
(Date:12/1/2015)... ... December 01, 2015 , ... The workstation boundaries for ... IMAGE Information Systems launches MED-TAB™ -- the world’s first portable DICOM-calibrated medical image ... 29 to December 4, 2015. , MED-TAB is expected to change teleradiology ...
(Date:12/1/2015)... ... December 01, 2015 , ... For ... That is why Hollister Incorporated has launched the VaPro Plus Pocket™ touch free ... in the VaPro touch free catheter portfolio,” said Michael Gresavage, Vice President North ...
Breaking Medicine News(10 mins):
(Date:12/1/2015)... -- Royal Philips  (NYSE: PHG, AEX: PHIA) ... that produces high-contrast images for all anatomies in situations ... the 2015 Radiological Society of North America Annual ... digital imaging solution providing grid-like contrast improvement and enhanced ... supports "first-time-right imaging" by decreasing the need for retakes ...
(Date:12/1/2015)... 2015 Array BioPharma Inc. (Nasdaq: ... Chief Executive Officer, Ron Squarer , ... Conference in New York.  The public is ... a webcast on the Array BioPharma website. ... --> , --> ...
(Date:12/1/2015)... , Dec. 1, 2015 Pharma Tech Outlook ... Top 10 Clinical Data Management Solution Providers - 2015 ... distinguished panel comprising CEOs, CIOs, VCs, analysts, and the ... illustrious list of top 10 clinical data management solution ... on pages 14 and 36 respectively). ...
Breaking Medicine Technology: