Older ALL Patients Would Benefit From Pediatric Treatment Approach

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When diagnosed in pediatric patients up to age 15, acute lymphoblastic leukemia (ALL) is treated with aggressive combination chemotherapy, and those patients typically see a remission rate above 80 percent.

The prognosis is not as good for so-termed young adults, those rare ALL patients who are between the ages 16 and 39. For those patients, standard treatment is generally chemotherapy followed by a bone marrow transplantation. Unfortunately their remission rate is around 40 percent.

Findings from a new study suggests that young adults would benefit from a different treatment strategy, according to one of the study's authors, Dr. Ron Ram of Tel Aviv University's Sackler Faculty of Medicine and the Davidoff Cancer Center at the Rabin Medical Center.

The critical difference is in not performing the transplantation, according to the published study, which appeared in the American Journal of Hematology.

Ram and colleagues carried out a systematic review of 11 comparative studies comparing the outcomes of 2,489 individuals aged 16-39 and were able to determine that it was pretty clear that not only was the transplantation likely not the best route, but also the young adult patient population does better when they are given the chemotherapy regimen generally reserved for the pediatric population.

The consequent remission rates for young adults is closer to that of children in these instances and the relapse rates are much lower.

"The long-term survival of these young adults increased significantly when following the pediatric treatment," said Dr. Ram. "There was a worry that the patients might suffer or even die from the toxicity of the treatment, but toxicity rates remained the same. With the pediatric treatment, patients were more frequently in remission and had prolonged survival without bone marrow transplantation - which itself is hard on the body.

"For a 16-20 year old, I would push them towards a pediatric regime," said Dr. Ram.

Source: Medical News Today

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