Related Experiment Video
Updated: Aug 8, 2026
10:49
Pre-clinical Evaluation of Tyrosine Kinase Inhibitors for Treatment of Acute Leukemia
Published on: September 18, 2013
Acute lymphoblastic leukemia in children: current status, controversies, and future perspective
Critical Reviews in Oncology/Hematology
|January 1, 1983
Summary
Childhood acute lymphoblastic leukemia (ALL) treatment is evolving. Effective therapies are improving disease-free survival (DFS) by overriding traditional prognostic factors and reducing treatment toxicity.
Area of Science:
- Pediatric Oncology
- Hematology
- Cancer Biology
Background:
- Childhood acute lymphoblastic leukemia (ALL) exhibits significant heterogeneity.
- Prognostic groups based on initial white blood cell (WBC) count and age show varying survival rates (90% good, 60% average, 45% poor).
- Additional factors like immunological and cytogenetic markers further define ALL's complexity.
Purpose of the Study:
- To refine prognostic group characteristics using biological factors.
- To evaluate current treatment strategies and their impact on disease-free survival (DFS).
- To investigate methods for reducing late toxicities associated with central nervous system (CNS) prophylaxis.
Main Methods:
- Tailoring therapy intensity based on prognostic groups.
- Utilizing multi-drug combinations for induction therapy.
- Implementing intrathecal (IT) methotrexate (MTX) for CNS prophylaxis, with or without cranial radiation (CXRT).
Main Results:
- Current CNS prophylaxis shows a 5% relapse rate across all prognostic groups.
- Late neuropsychological defects (decreased IQ, visual-motor incoordination) are observed, particularly in younger children, due to CXRT and IT MTX.
- Intensive therapy failed to improve DFS in poor prognosis patients until 1980.
- The Berlin-Frankfurt-Muenster protocol demonstrates 70-75% DFS irrespective of initial WBC.
- Ultra-high-dose MTX without cranial radiation shows promise for poor prognosis patients.
- Prognostic factors may lose significance after 2 years of continuous remission.
Conclusions:
- Effective therapeutic strategies can override traditional prognostic factors in childhood ALL.
- Reducing the late toxicity of CNS prophylaxis is a critical area of research.
- Further investigation is needed to determine the optimal duration of therapy and the role of testicular biopsies/radiation.
- Novel therapeutic approaches, including ultra-high-dose MTX and NHL-type therapy for leukemia/lymphoma, show potential for improved outcomes.
Related Concept Videos
02:57Targeted Cancer Therapies
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
There are several types of targeted therapies against specific...
01:21Lineage Commitment
Commitment is the process whereby stem cells:
01:22Bone Marrow Sampling and Transplants
Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy the...
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy the...