Acute Lymphoblastic Leukemia, the Most Common Childhood Cancer, Is Curable Without Preventive Cranial...( St. Jude study shows personalized che...),Health

St. Jude study shows personalized chemotherapy can improve cure rate and avoid the use of radiation in acute lymphoblastic leukemia treatment

MEMPHIS, Tenn., June 24 /PRNewswire-USNewswire/ -- Childhood acute lymphoblastic leukemia (ALL) can be successfully treated using a carefully personalized chemotherapy regimen without cranial radiation, investigators at St. Jude Children's Research Hospital have found. Such radiation of the brain was once a standard ALL treatment to prevent recurrence of the leukemia in the central nervous system (CNS).

Despite radiation's success in treating ALL, it produces side effects that include second cancers, stunted growth, hormone imbalances and cognitive deficits. Optimized use of anticancer drugs, especially those instilled directly into the spinal fluid, have enabled clinicians to reduce radiation use, and only patients at highest risk for relapse have received cranial radiation.

Now, St. Jude researchers have established that radiation can be safely eliminated in all patients with the use of highly effective chemotherapy regimens. The findings appear in the June 25, 2009, issue of the New England Journal of Medicine.

"Cranial radiation was an invaluable treatment when it was introduced by St. Jude oncologists in the mid-1960s," said Ching-Hon Pui, M.D., chair of the St. Jude Department of Oncology and an American Cancer Society Professor. "It controlled CNS leukemia and boosted the cure rate for ALL from only 4 percent to 50 percent. But radiation's side effects led to the steady reduction of dosages and limited use to the highest-risk patients." According to Pui, the paper's lead author, about 20 percent of the approximately 3,400 cases of childhood ALL diagnosed in the U.S. each year are still treated with radiation. In some developing countries, radiation continues to be used in the majority of children with ALL.

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