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Related Experiment Videos

Late relapsing childhood lymphoblastic leukemia

A Vora1, L Frost, A Goodeve

  • 1Molecular Haematology Unit, Children's and Royal Hallamshire Hospital, Sheffield, UK. A.J.Vora@Sheffield.ac.uk

Blood
|September 25, 1998
PubMed
Summary

Childhood leukemia can rarely relapse over 10 years after remission. Genetic analysis confirmed these were true recurrences, not new cancers, highlighting the need for long-term monitoring.

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Outcome of relapsed infant acute lymphoblastic leukemia treated on the interfant-99 protocol.

Leukemia·2017

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Molecular Biology

Background:

  • Childhood lymphoblastic leukemia (ALL) is typically considered cured after long-term remission.
  • Late relapses of ALL after 10 or more years of remission are uncommon but can occur.

Purpose of the Study:

  • To investigate the nature of late relapses in childhood ALL.
  • To differentiate between true leukemia recurrence and secondary malignancies after prolonged remission.

Main Methods:

  • Analysis of children treated on Medical Research Council ALL protocols (1970-1984).
  • DNA extraction from archived marrow smears for polymerase chain reaction (PCR) analysis.
  • Identification of identical Ig heavy chain (IgH) or T-cell receptor (TCR) gene rearrangements at diagnosis and relapse.

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Main Results:

  • Of 1,134 survivors in CR1 for ≥10 years, 12 (approx. 1%) relapsed.
  • PCR confirmed identical IgH/TCR gene rearrangements in all 8 cases with successful DNA extraction, indicating true recurrences.
  • All patients achieved a second complete remission (CR2) after further therapy.

Conclusions:

  • A small but persistent risk of late relapse exists for childhood ALL.
  • The findings raise questions about long-term leukemia cell dormancy and the definition of cure.
  • Long-term follow-up may be necessary for some childhood ALL survivors.