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Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
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Treatment delay and the risk of relapse in pediatric acute lymphoblastic leukemia

Amelia Yeoh1, Anna Collins2, Kahlia Fox2

  • 1a Discipline of Paediatrics , University of Adelaide , Adelaide , South Australia , Australia.

Pediatric Hematology and Oncology
|March 14, 2017
PubMed

Insights

Treatment delays in pediatric acute lymphoblastic leukemia (ALL) due to toxicity did not increase relapse risk overall. However, longer delays during maintenance therapy showed a trend towards fewer relapses in children with ALL.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Clinical Research

Background:

  • Toxicity-induced chemotherapy interruptions are common in pediatric acute lymphoblastic leukemia (ALL).
  • Concerns exist that these treatment delays may negatively impact patient outcomes.
  • Previous studies suggest poorer outcomes with reduced therapy compliance.

Purpose of the Study:

  • To investigate the association between chemotherapy treatment delays and relapse risk in pediatric ALL patients.
  • To analyze delays during different phases of treatment: total, intensive, and maintenance.

Main Methods:

  • Retrospective review of 141 pediatric ALL patients treated between 2003 and 2013.
  • Analysis of cumulative chemotherapy delay lengths during total, intensive, and maintenance phases.
  • Comparison of relapse risk between patients with shorter versus longer treatment delays (median and quartile analysis).

Main Results:

  • No significant difference in relapse risk was observed for delays during the total treatment duration or the intensive phase.
  • A trend towards reduced relapse risk was noted with longer delays during the maintenance phase.
  • A statistically significant decrease in relapses was found in patients experiencing the longest delays during maintenance therapy.

Conclusions:

  • Chemotherapy delays due to toxicity in pediatric ALL do not universally increase relapse risk.
  • Extended treatment delays during the maintenance phase may be associated with a lower risk of relapse in pediatric ALL.
  • Further research is warranted to understand the mechanisms behind this observed association.

Keywords:
Acutedelaysleukemialymphoblasticrelapsetreatment

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