More than a third of children who die from a particularly deadly form of leukemia would be saved if doctors used three existing drugs more aggressively – administering them at much higher doses and over a longer period of time. That is one of several important conclusions drawn from a long-term study, published in the October issue of the Journal of Clinical Oncology, that tested a high-dose drug regimen in 125 young leukemia patients and tracked their outcomes for an average of nine years.
The study, conducted by researchers at nine universities and research hospitals, was led by Barbara L. Asselin, M.D., associate professor of Pediatrics and Oncology at the James P. Wilmot Cancer Center at the University of Rochester. It focused on children with T-cell acute lymphoblastic leukemia, or T-ALL, which accounts for 15 percent of all childhood leukemia cases and is fatal in nearly four in 10 children. While dozens of drugs are routinely used to treat children with the disease, the study sheds new light on the fundamental questions about their use: Which combination of those drugs is most effective? And, what are the highest doses that can be given without subjecting children to additional risks – such as kidney damage and neurological problems – that might be caused by the powerful drugs themselves?
To find out, the researchers drew on earlier studies that had pointed to the effectiveness of three cancer-killing drugs – methotrexate, asparaginase, and doxorubicin. The researchers devised an experimental regimen in which all three would be administered at whopping doses – up to five times higher than usual – and for durations of several months instead of weeks. Between 1981 and 2000, 125 children with T-ALL received the experimental treatment. Afterward, each patients progress was followed by the researchers for an average of nine years. More than 25 percent of the patients were followed into their 20s, and some into their early 30s. The researchers were interested not only in whether the children survived the cancer, but also whether the high-dose chemotherapy produced any debilitating long-term effects.
Chris DiFrancesco | EurekAlert!
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