-- Robert Preidt
WEDNESDAY, April 11 (HealthDay News) -- Additional chemotherapy
may a better option than bone marrow transplant for some children
with acute lymphoblastic leukemia who don't respond to an initial
intense regimen of chemotherapy called "induction therapy," a new
Acute lymphoblastic leukemia, or ALL, is a cancer of the blood
and bone marrow.
According to study co-author Dr. Ching-Hon Pui, failure to
improve after induction therapy is rare, happening in just 2
percent to 3 percent of children with ALL. But when it does happen,
these children's risk for a bad outcome rises considerably, so they
often then become candidates for a bone marrow transplant.
However, the new study suggests that that option may not always
be the only one.
"Some patients and their parents will be relieved to know that transplantation is not necessary for cure," said Pui, chair of the oncology department at St. Jude Children's Research Hospital in Memphis, Tenn. His team published their findings in the April 12 issue of the New England Journal of Medicine.
In the study, Pui and his colleagues tracked more than 1,000
children with ALL who did not go into remission after four to six
weeks of induction therapy. The patients' cancer was diagnosed when
they were between the ages of 1 to 5 years.
The overall survival rate for children with ALL who fail to go
into remission following induction therapy was 32 percent. However,
the rate was 72 percent in a subset of patients who had additional
instead of a bone marrow transplant.
Pui's group noted that this type of patient had a form of ALL
that begins in white blood cells destined to become B cells
(B-lineage ALL). They accounted for about 25 percent of the more
than 1,000 patients who did not go into remission following
Patients who fail induction therapy but may not require
transplant, therefore, "are the patients who have B-cell precursor
leukemia with no other adverse features," Pui said. "The remaining
patients [who failed induction therapy] will be certain that
transplantation is their best treatment for cure."
Another expert in leukemia care said the study offers valuable
"The study shows that even in these patients who have a poor response, there are a few subgroups that ultimately do well while there are other subgroups that do poorly and need bone marrow transplantation," said Dr. Arlene Redner, associate chief of oncology at Steven and Alexandra Cohen Children's Medical Center of New York in New Hyde Park, N.Y.
"This study will allow us to tailor our therapy in these patients and know that some of the patients who don't go into remission after the first month of therapy need bone marrow transplantation while others do not," she explained.
Still, the study did have its limits, Redner added. "The
problems with the study are that the children were not all treated
the same way and were treated over a long time period from 1985 and
2000. We now subdivide patients and treat them differently than
during that time period."
The U.S. National Cancer Institute has more about
childhood acute lymphoblastic leukemia.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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