Progress Report: Good News About Leukemia

Acute lymphoblastic leukemia survival rates rising

(RxWiki News) Children's leukemia is a cancer with a lot of funding and driven research behind it, with some of the best and brightest oncologists striving to improve every aspect of care. A progress report on survival rate now shows the results of their hard work.

The largest study to date of children's acute lymphoblastic leukemia (ALL) showed significant gains in survival rate in the past fifteen years, which researchers attribute to advances in treatment profiles, as well as advances in early recognition and treatment of complications. Patients under one year of age, who have unique problems in comparison to other pediatric cancer patients, was the only group without significant change in survival rate.

"Ask your oncologist about their use of genetic profiling."

The research team focused on areas to improve treatment, noting that drug toxicity from aggressive chemotherapy was a complication shown to be increased in the past decade. The chemotherapy used today remains similar to the initial methotrexate, cytarabine, and 6-mercaptopurine cocktail developed in the 1970s, but dosages have been fine-tuned with study and refinement over the years, most recently using genetic analysis to profile cancers for higher doses.

"Childhood leukemia was virtually incurable until the early 1960s, but this study shows that we’re 90 percent of the way toward our goal of curing all children with this disease," said the study's lead author Stephen Hunger, M.D., at the University of Colorado School of Medicine. For children's leukemia, "New drugs and new drug combinations have increased survival rates and helped children live longer and better, and we continue to refine these therapies. Nevertheless, we still have important work to do to help the remaining 10 percent of patients who don't survive."

"Different approaches are still needed to treat infants with leukemia,” Dr. Hunger said. "Clinical trials are starting to look at combining newer, more targeted drugs with conventional chemotherapy, and we’re hopeful that this approach will improve outcomes for infants." Dr. Hunger was quick to promote the importance of all the research done on children with leukemia, stating that “Today, more than half of all children with cancer are treated through clinical trials, compared to less than five percent of adults with cancer. Without a doubt, more and more children and older adolescents with leukemia are cured today because of the patients and parents who were willing to participate in clinical research."

Except for patients under the age of one year, survival rates were increased for all subgroups of children including gender, race, ethnicity, and subtype of ALL. Five year survival was reported as 90.4 for the clinical trials ending in 2005. The survival rate for infants with leukemia has held steady at around 50 percent, but pediatric oncologists should take note that for infants, fatal complications from aggressive chemotherapy were higher than ever before.

While a lot of funding has been poured into studying leukemia on an individual basis to optimize treatment, standard leukemias with standard therapies remain the bulk of new cases and are just as difficult to successfully treat.

The findings were published March 12 in the Journal of Clinical Oncology. The full paper, linked at the end of this article, is available to the public.

Study authors disclosed financial relationships with pharmaceutical corporations, including EUSA Pharma, sano-aventis, Teva Pharmaceutical Industries, Bristol-Myers Squibb, Enzon Pharmaceuticals, Sigma Tau Pharmaceuticals, and Genzyme.

Review Date: 
March 23, 2012