Best Treatments for Childhood Leukemia

Leukemia patients may avoid marrow transplants with additional chemotherapy

(RxWiki News) Over the last few decades, the ability of doctors to successfully treat childhood leukemias has risen dramatically. For the small group of patients that don't respond to initial therapy, figuring out why has become an important research topic.

Researchers concluded that the current mainstay in leukemia treatment, several weeks of intensive high dose chemotherapy known as induction therapy, is not the final chapter in acute lymphoblastic leukemia treatment.

For this group of patients, especially T cell leukemias, a secondary round of chemotherapy was the best solution.

B cell leukemias were more likely to benefit from alternative therapies other than chemotherapy.

"Talk to your oncologist about post-induction therapies for leukemias."

Long term survival rates for childhood leukemias such as acute lymphoblastic leukemia have risen dramatically over the last few decades, with overall survival higher than 80 percent on average. For patients that don't respond to the intensive chemotherapy session known as induction therapy, ten-year survival rates are close to 30 percent.

However in this study, patients with B cell leukemias that did not respond to the induction therapy demonstrated ten year survival rates of 72 percent when given a lower, longer dose of chemotherapy after initial treatment.

Data from this research will be used in determining the best treatment for leukemia patients, especially the significant finding that expensive and grueling bone marrow transplants are not always the best fall back solution.

"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 study author Ching-Hon Pui, MD.

"These results tell us that induction failure should no longer be considered an automatic indication for a transplant."

In a very successful collaboration between many different research facilities and oncology groups, the study used data from fourteen different countries, following 44,017 children with acute lymphoblastic leukemia for 15 years.

The study was published in the New England Journal of Medicine on April 12, 2012.

The work was supported in part by a National Cancer Institute grant from the Children's Cancer Group, the Pediatric Oncology Group and St. Jude's American Lebanese Syrian Associated Charities.

Review Date: 
April 17, 2012