Two Childhood Leukemia Retrospective Studies Indicate Ways to Improve Treatment

Event-free survival improved for more than 18,000 patients with childhood acute lymphoblastic leukemia in the United States and Italy by using medications and reducing or eliminating cranial radiation therapy, according to two review studies.

In a review of the records of 13,298 children in the Children’s Cancer Group study, Paul S. Gaynon, et al, found that 10 year event-free survival improved for high and standard risk B-precursor patients. The survival rates were 68 percent for standard risk and 58 percent for high risk patients from 1983 to 1988; 77 percent and 63 percent, respectively, from 1989 to 1995; and 78 percent and 67 percent from 1996 to 2002. Event-free survival also improved for patients with T-cells at 65 percent and 56 percent, 78 percent and 68 percent, and 70 percent and 72 percent, respectively for those intervals.

The improvements in survival coincided with increased rational treatment that included additional intrathecal methotrexate replacing cranial radiation, the authors wrote in the Dec. 17, 2009, issue of Leukemia.

Progressive intensification of systemic therapy and a decrease in cranial radiation were also credited for improving the survival of 4,685 children treated for acute lymphoblastic leukemia in a series of Italian Association of Pediatric Hematology and Oncology studies. The analysis by Valentino Conter, et al, discovered that10 year event-free survival increased from 53 percent to 72 percent, and survival improved from 64 percent to 82 percent over the course of five studies.

Results markedly improved for high-risk patients when conventional therapy was intensified with three polychemotherapy blocks and double delayed intensification, the authors concluded in an article printed in Leukemia on December 17.