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:11/26/2015)... ... November 26, 2015 , ... Inevitably when people think Thanksgiving, they also think ... during the Black Friday and Cyber Monday massage chair sales to receive ... high and low to find the best massage chair deals, they can see all ...
(Date:11/26/2015)... ... 2015 , ... Somu Sivaramakrishnan announced today that he joined ... offers travelers, value and care based Travel Services, including exclusive pricing on a ... cabin upgrades and special amenities such as, shore excursions, discounted fares, travel gifts ...
(Date:11/26/2015)... NE (PRWEB) , ... November 26, 2015 , ... Jobs ... searched by healthcare professionals and offered by healthcare staffing agency Aureus Medical Group ... during the month of October 2015 among those searching for healthcare jobs through the ...
(Date:11/26/2015)... ... November 26, 2015 , ... WorldCare International, Inc., the first ... annual Employee Benefits Conference. The Employee Benefits Conference was hosted by the International ... November 11th, 2015. The conference was held at the Hawaii Convention Center in ...
(Date:11/26/2015)... ... November 26, 2015 , ... ... for mental health and wellness consultation, has collaborated with Women’s Web – ... their reader’s queries on topics on mental and emotional well-being relationship, life ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... PUNE, India , November 26, ... --> --> ... Research Report" and "Investigation Report on ... 2019 and 2021 forecasts data and ... library. . ...
(Date:11/26/2015)... DUBLIN , November 26, 2015 ... has announced the addition of the  ... in the European Cell Surface Marker ... Emerging Opportunities"  report to their offering.  ... announced the addition of the  "2016 ...
(Date:11/25/2015)... -- The American Academy of Pediatrics (AAP), American Congress ... of Dimes cheered today,s signature into law of ... 2015 (S.799), which takes much-needed strides to ... drugs, such as opioids, and to improve their ... have worked together leading advocacy efforts for its ...
Breaking Medicine Technology: