Related Experiment Video
Updated: Jul 13, 2026
Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
Published on: October 17, 2025
[Evaluation of a modified induction chemotherapy in children with acute lymphoblastic leukemia]
Ci Pan1, Long-jun Gu, Hui-liang Xue
1Department of Hematology/Oncology, Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200127, China.
Insights
A modified chemotherapy protocol for childhood acute lymphoblastic leukemia (ALL) showed equal efficacy to the previous one but with significantly reduced infection rates and related deaths. This new protocol offers a safer treatment option for pediatric ALL patients.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Chemotherapy
Context:
- Acute lymphoblastic leukemia (ALL) is the most common childhood cancer.
- Effective induction chemotherapy is crucial for improving treatment outcomes in pediatric ALL.
- Previous protocols carried significant risks of treatment-associated mortality and morbidity.
Purpose:
- To compare the efficacy and safety of a modified induction chemotherapy protocol (ALL Protocol 2005) against a standard protocol (ALL-XH-99) in children with ALL.
- To evaluate treatment outcomes, including complete remission rates, infection rates, and treatment-associated mortality.
- To assess the impact of reduced treatment intensity on safety and efficacy.
Summary:
- A study involving 311 newly diagnosed childhood ALL patients compared ALL-XH-99 (n=243) with the modified ALL Protocol 2005 (n=68).
- Both protocols achieved similar complete remission rates (91.8% vs. 95.6%).
- ALL Protocol 2005 demonstrated significantly lower infection rates (23.5% vs. 54.7%), no severe infections, and no infection-related deaths, alongside a shorter time to remission.
Impact:
- The ALL Protocol 2005 offers comparable efficacy to ALL-XH-99 in pediatric ALL induction therapy.
- This modified protocol significantly enhances patient safety by reducing infection-related complications and mortality.
- The findings support the adoption of ALL Protocol 2005 for improved outcomes in childhood ALL treatment.
Objective:
To improve the treatment outcome of children with acute lymphoblastic leukemia (ALL), and to evaluate the efficacy and safety of a modified induction chemotherapy between the two protocols used to treat children with ALL in Shanghai Children's Medical Center.
Methods:
From Jan. 1st, 1999 to Mar. 1st, 2006, 311 patients with newly diagnosed childhood ALL, who underwent induction chemotherapy for over 10 days, were eligible for analysis. Group 99 (n = 243) patients who were admitted before May 1st, 2005, were treated with ALL-XH-99 Protocol, whereas 68 patients admitted afterwards, defined as Group 05, were treated with ALL Protocol 2005 which was based on ALL-XH-99 Protocol but the treatment intensity was reduced to decrease treatment associated mortality. Clinically, the distributions of the initial data from the patients, treatment responses, complete remission rates after therapy, and treatment-associated infections in the two groups were evaluated.
Results:
Patients from the two groups obtained similar complete remission rate (91.8% vs. 95.6%, P = 0.29), while patients from Group 05 were benefited more from their therapy. They had lower therapy associated infection rate (23.5% vs. 54.7% in Group 99, P < 0.01), and no severe infection (0 vs. 9.1% in Group 99) and no infection related death occurred (0 vs. 3.7% in Group 99). Patients in the Group 05 also had shortened period from the beginning day of the initial therapy to complete remission (32.34 +/- 3.36 days vs. 34.18 +/- 4.96 days, P < 0.01).
Conclusions:
ALL Protocol 2005 had the same efficacy as ALL-XH-99 Protocol had in the induction therapy in treating children with ALL, but it was safer than ALL-XH-99.
