Related Experiment Video
Updated: May 28, 2026
Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
Published on: October 17, 2025
Comparative outcomes of Thai children with acute lymphoblastic leukemia treated with two consecutive protocols:
Pacharapan Surapolchai1, Samart Pakakasama, Nongnuch Sirachainan
1Department of Pediatrics, Mahidol University, Bangkok, Thailand.
Insights
This study evaluated outcomes for pediatric acute lymphoblastic leukemia (ALL) patients treated with St Jude protocols. Improved survival rates were observed, though sepsis remained a significant risk factor for both overall and event-free survival.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Trials
Background:
- Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
- Optimizing treatment protocols is crucial for improving pediatric cancer survival rates.
Purpose of the Study:
- To assess outcomes and prognostic factors in children with ALL treated with modified St Jude protocols.
- To evaluate the effectiveness of two distinct treatment protocols implemented between 1997 and 2008.
Main Methods:
- Retrospective analysis of pediatric ALL patients treated at Ramathibodi Hospital.
- Comparison of event-free survival (EFS) and overall survival (OS) rates between two modified St Jude protocols.
- Identification of adverse prognostic indicators.
Main Results:
- Event-free survival rates at 3 and 5 years were high for both protocols (e.g., 88.0 ± 3.8% at 5 years for the current protocol).
- Adverse prognostic factors identified included obesity, high presenting leukocyte count, high-risk group, persistent blasts, and sepsis.
- Sepsis was associated with inferior overall survival in both protocols.
Conclusions:
- Modified St Jude protocols demonstrate effective treatment for pediatric ALL, with steady improvements in cure rates.
- Risk stratification and reduction of treatment-related toxicities, particularly infections, are key future challenges.
- A multidisciplinary approach is essential for optimal pediatric cancer care.
Abstract:
The aim of this study was to determine outcomes and prognostic features of children with acute lymphoblastic leukemia (ALL) treated with two modified St Jude Children's Research Hospital protocols at Ramathibodi Hospital (1997-2008). Event-free survival rates of the "previous protocol" were 88.3 ± 3.3% and 83.0 ± 3.9% and of the "current protocol" were 89.9 ± 3.4% and 88.0 ± 3.8%, at 3 and 5 years, respectively. Adverse prognostic features were identified only in the previous protocol study, including obesity, presenting leukocytes >100 × 10(9)/L, high-risk group, persistent blasts in a day-15 marrow and sepsis. Sepsis also conferred inferior overall survival rates of patients in both protocols. Steady improvement in cure rate over the past decade has clearly demonstrated the optimal use of treatment protocols and a multidisciplinary approach to implementing pediatric cancer care in Ramathibodi Hospital. Our future challenges are refinement in risk and treatment stratification and reduction of treatment-related toxicities, prioritizing death from infections.
