Extending chemo slashes risk of aggressive childhood leukemia coming back

Medical Xpress / Princess Máxima Ctr. / Annual conference of the American Society of Hematology ^ | Dec. 10, 2022 | Dr. Rob Pieters et al

[ConservativeMind]

Many children with acute lymphoblastic leukemia (ALL) have a good outcome of their disease. After two years of chemotherapy treatment, 9 out of 10 children are cured. But some children have a more aggressive form of disease. For example, children with a so-called Ikaros change in the DNA of their leukemia cells have a greater risk of their disease coming back after treatment.

Children with Ikaros leukemia received an extra year of chemotherapy in the "maintenance phase" on top of the first two years of treatment. This change lowered the risk of their cancer coming back by threefold: this happened in only 9% of them, compared to 26% of the children in the previous treatment protocol.

87% of children with Ikaros leukemia survived their disease for five years without their cancer coming back, an improvement on the 72% in the previous protocol. Because of the extra year of chemotherapy, this group of children had a slightly higher risk of infection, but these were treatable. The extended therapy did not lead to any additional side effects.

Analysis of data from all children with ALL, regardless of subtype, showed that the five-year survival rate has improved stepwise over the past 30 years from 80% to 94% under the ALL-11 protocol.

In the ALL-11 protocol, doctors also looked at the benefit of a less intensive treatment plan for three groups of children. This included children with a DNA change in their leukemia cells and children with Down syndrome.

These children received treatment without or with a lower dose of anthracyclines, a leukemia drug that increases heart damage and infections. The reduced treatment proved successful: children had the same or even a better chance of survival, while their quality of life improved due to a lower risk of infections and damage to the heart.

[ConservativeMind]

1/3 the relapse rate for one extra year of chemo.

[ConservativeMind]

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[lee martell]

That extra year of chemo seems to provide a lasting benefit. I have always heard chemo therapy can be quite rough on the whole body of the patient.
I can only imagine how that would be for a child. Maybe therapies have improved over the last 40 years when I first gave the topic any thought.
40 years ago, I knew of a popular teacher of commercial illustration who received that treatment.