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:12/7/2016)... ... December 07, 2016 , ... AlignLife clinics nationwide are giving back ... not fortunate enough to receive bountiful gifts wrapped tightly under a Christmas Tree. ... the children of the world. , In exchange for generous donations, customers will receive ...
(Date:12/7/2016)... ... 07, 2016 , ... Sharon Kleyne, host of the nationally syndicated radio program, ... Voice of America, declared on her radio program in November 2016 the need to ... these bullies attack leaders in corporate America, they are trying to take advantage of ...
(Date:12/7/2016)... Phoenix, Arizona (PRWEB) , ... December 07, 2016 , ... ... Juvederm®, Just in Time For The Holiday Party Season. Save Up To 33% Off ... and Laser Salon is providing the Phoenix Valley with Delightful Deals on ...
(Date:12/7/2016)... ... December 07, 2016 , ... The medical profession is well aware that heart ... major study analyzing heart attacks among 138,602 people recorded a 35% higher number of ... would all agree of course–no time of year is a good time for a ...
(Date:12/7/2016)... (PRWEB) , ... December 07, ... ... Technologies, announced its newest portable bioelectronic medicine device WellnessPro Plus for consumers ... Plus substantially enhances the WellnessPro platform by expanding the treatment modalities available ...
Breaking Medicine News(10 mins):
(Date:12/7/2016)... ZIONA SCIENCE PARK , Israel ... company Kadimastem (TASE: KDST) announced today the signing of a memorandum ... between the companies. The synergy between the companies will assist in ... as a worldwide leader in innovative treatment for severe diseases in ... ...
(Date:12/7/2016)... 7, 2016  Organovo Holdings, Inc. (NASDAQ: ... focused on delivering scientific and medical breakthroughs using ... and Chief Executive Officer Keith Murphy ... December 14, 2016 at 1:00 p.m. Eastern Time ... yet familiar with the Company, an informational video ...
(Date:12/7/2016)... The global  blood screening ... USD 3.9 billion by 2024, based on a ... growth of the market is attributed to the ... by the market players. Demand for blood screening ... rising awareness about transfusion-transmitted diseases, and technological developments ...
Breaking Medicine Technology: