Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

In childhood leukemia study, aggressive chemotherapy cuts deaths by 37%

02.10.2003


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 patient’s 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.


Of the 125 children studied, 93 of them were cured, yielding a survival rate of 75 percent compared to survival rates of between 60 and 65 percent for treatment regimens that used much lower drug doses. Years after treatment, despite the more aggressive chemotherapy, the patients did not experience medical problems beyond those reported in those who had received lower doses of the drugs, with one exception. Patients who had received higher doses of doxorubicin experienced slightly higher rates of cardiomyopathy, a weakening of the heart muscle that can usually be controlled with medication.

"This study tells us, without question, that we should be using these drugs much more aggressively," said Asselin. "Giving these drugs at much higher dosages dramatically improves a child’s chances for survival, and does not pose a significantly greater risk for long-term negative effects. The evidence is so compelling that we are recommending that this new approach become the standard treatment for all children diagnosed with this form of leukemia."

In addition to high-dose chemotherapy, children in the study received low-dose radiation therapy to the brain, where cancerous cells are most likely to survive chemotherapy and cause a relapse of leukemia in the future. Asselin and her colleagues credit the combination of chemotherapy and radiation with preventing relapse among the majority of children in the study, thereby minimizing the greatest threat to their long-term survival. Equally important, the use of low-dose radiation to the brain did not result in a decline in cognitive abilities that had been reported in earlier studies in which children had received higher does of radiation.

"Our goal in this study, and in our careers as researchers, is to find the right balance of treatment for these children," said Asselin. "We want to deliver treatment that is powerful enough to kill their cancer, yet not so toxic that the treatment itself robs them of a normal life afterward. We want them to be healthy – to grow up to play and have fun and do well in school and have a normal quality of life."

The study was funded by the National Institutes of Health and conducted by the Dana-Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium. Co-authors of the paper were John M. Goldberg, Lewis B. Silverman, Donna E. Levy, Virginia Kimball Dalton, Richard D. Gelber, Leslie Lehmann, Harvey J. Cohen, and Stephen E. Sallan.

Chris DiFrancesco | EurekAlert!
Further information:
http://www.urmc.rochester.edu/

More articles from Health and Medicine:

nachricht New nanomedicine slips through the cracks
24.04.2019 | University of Tokyo

nachricht Sugar entering the brain during septic shock causes memory loss
23.04.2019 | Rensselaer Polytechnic Institute

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Energy-saving new LED phosphor

The human eye is particularly sensitive to green, but less sensitive to blue and red. Chemists led by Hubert Huppertz at the University of Innsbruck have now developed a new red phosphor whose light is well perceived by the eye. This increases the light yield of white LEDs by around one sixth, which can significantly improve the energy efficiency of lighting systems.

Light emitting diodes or LEDs are only able to produce light of a certain colour. However, white light can be created using different colour mixing processes.

Im Focus: Quantum gas turns supersolid

Researchers led by Francesca Ferlaino from the University of Innsbruck and the Austrian Academy of Sciences report in Physical Review X on the observation of supersolid behavior in dipolar quantum gases of erbium and dysprosium. In the dysprosium gas these properties are unprecedentedly long-lived. This sets the stage for future investigations into the nature of this exotic phase of matter.

Supersolidity is a paradoxical state where the matter is both crystallized and superfluid. Predicted 50 years ago, such a counter-intuitive phase, featuring...

Im Focus: Explosion on Jupiter-sized star 10 times more powerful than ever seen on our sun

A stellar flare 10 times more powerful than anything seen on our sun has burst from an ultracool star almost the same size as Jupiter

  • Coolest and smallest star to produce a superflare found
  • Star is a tenth of the radius of our Sun
  • Researchers led by University of Warwick could only see...

Im Focus: Quantum simulation more stable than expected

A localization phenomenon boosts the accuracy of solving quantum many-body problems with quantum computers which are otherwise challenging for conventional computers. This brings such digital quantum simulation within reach on quantum devices available today.

Quantum computers promise to solve certain computational problems exponentially faster than any classical machine. “A particularly promising application is the...

Im Focus: Largest, fastest array of microscopic 'traffic cops' for optical communications

The technology could revolutionize how information travels through data centers and artificial intelligence networks

Engineers at the University of California, Berkeley have built a new photonic switch that can control the direction of light passing through optical fibers...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Revered mathematicians and computer scientists converge with 200 young researchers in Heidelberg!

17.04.2019 | Event News

First dust conference in the Central Asian part of the earth’s dust belt

15.04.2019 | Event News

Fraunhofer FHR at the IEEE Radar Conference 2019 in Boston, USA

09.04.2019 | Event News

 
Latest News

Proteins stand up to nerve cell regression

24.04.2019 | Life Sciences

New sensor detects rare metals used in smartphones

24.04.2019 | Life Sciences

Controlling instabilities gives closer look at chemistry from hypersonic vehicles

24.04.2019 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>