Navigation Links
Chemotherapy proves life-saving for some leukemia patients who fail induction therapy
Date:4/11/2012

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 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
summer.freeman@stjude.org
901-595-3061
St. Jude Children's Research Hospital
Source:Eurekalert

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:
*Name:
*Comment:
*Email:
(Date:2/25/2017)... ... February 25, 2017 , ... FCPX users now have the ability ... Film Studios. With ProSharpen Color users have total control over sharpening amount, sharpening radius, ... range. With color spectrum tools users can visually see the color range effected with ...
(Date:2/24/2017)... ... February 24, 2017 , ... WHAT: , The New Jersey ... as well as advocacy for the state and region‘s technology businesses, hosted their ... The Council's Innovation Forecast event highlights innovation throughout the region from small to ...
(Date:2/24/2017)... ... February 24, 2017 , ... In the Health Care ... a top priority because it’s not if you will be attacked, but when.” However, ... it comes to digital health care. , Improvements in auditing and monitoring have taken ...
(Date:2/24/2017)... (PRWEB) , ... February 24, 2017 , ... With ProGlass ... Cut Pro X . Users have total control over position, rotation, distortion, edge softness, ... all within Final Cut Pro X. , With ProGlass Prism users are given the ...
(Date:2/24/2017)... ... February 24, 2017 , ... Indiana Fiber Network (IFN) President and ... this year. Dyer started as the Chairman of the Management Committee when IFN ... the corporation including the recruitment of investor/owners and development of the business plan. ...
Breaking Medicine News(10 mins):
(Date:2/24/2017)... Feb. 24, 2017 Research and Markets has announced ... - Industry Forecast to 2025" report to their offering. ... The Global Empty Capsules Market is ... decade to reach approximately $2.9 billion by 2025. This ... segments on global as well as regional levels presented in the research ...
(Date:2/24/2017)... Feb. 24, 2017 Physician General Dr. ... Alcohol Programs Jennifer Smith commended South Central ... for and using naloxone, a life-saving overdose reversal drug. ... a recovery specialist and overdose survivor who was saved ... "A significant part of fighting the opioid ...
(Date:2/24/2017)... YORK , Feb. 24, 2017 ... Monteverde & Associates PC , a boutique securities firm ... New York City , announces that a class ... Massachusetts  against Inotek Pharmaceuticals Corporation ... of the Company,s securities between July 23, 2015 and December ...
Breaking Medicine Technology: