Advertisement
 

doctorslounge.com

 
Powered by
Careerbuilder

 

                    Home  |  Forums  |  Humor  |  Advertising  |  Contact
   Ask a Doctor

   News via RSS

   Newsletter

   Oncology

   News

 

 Conferences


   CME

   Forum Archives

   Diseases

   Symptoms

   Labs

   Procedures

   Drugs

   Links
   Specialties

   Cardiology

   Dermatology

   Endocrinology

   Fertility

   Gastroenterology

   Gynecology

   Hematology

   Infections

   Nephrology

   Neurology

   Oncology

   Orthopedics

   Pediatrics

   Pharmacy

   Primary Care

   Psychiatry

   Pulmonology

   Rheumatology

   Surgery

   Urology

   Other Sections

   Membership

   Research Tools

   Medical Tutorials

   Medical Software

 

 Headlines:

 
 

Back to Oncology Articles

Friday 31st March, 2006

A new test could give hospitals with limited resources an affordable way to improve the outcome of ALL treatment.
 

tellfrnd.gif (30x26 -- 1330 bytes)send to a friend
 
prntfrnd.gif (30x26 -- 1309 bytes)printer friendly version

  Related
 
Stronger therapy better in AML with normal genetics

Investigators at St. Jude Children's Research Hospital have developed a relatively simple and inexpensive test that identifies children with acute lymphoblastic leukemia (ALL) who have responded well enough to their first round of chemotherapy that they might be successfully treated with a much less aggressive follow-up treatment.

The new test could give hospitals with limited resources an affordable way to improve the outcome of ALL treatment for many children by reducing chemotherapy side effects.

A report on this new technique appears in the March pre-publication online issue of Blood.

The test measures minimal residual disease (MRD)--the small number of leukemic cells that survive after remission induction therapy. This measurement helps clinicians identify patients whose disease is highly responsive to chemotherapy and those who might be cured with milder and less toxic treatment.

The study found that the new test provides results that are acceptably close to those obtained with more complex and expensive MRD tests, which can be performed only at a few cancer centers worldwide. The new assay uses only one test tube with three probes that can distinguish leukemic cells from normal cells in the bone marrow of children with ALL taken after two weeks of chemotherapy, according to the paper's senior author, Dario Campana, M.D., Ph.D., a member of the St. Jude Hematology-Oncology and Pathology Departments.

The high cost and complexity of the more sophisticated MRD tests have impeded their use in countries with limited resources, Campana said. "That limited the number of children who could benefit from MRD assays," he said. "The test we developed will allow clinicians at institutions with limited resources to reliably identify children who could be spared the harsh side effects caused by intense chemotherapy."

The investigators used the new test to examine bone marrow cells collected from 380 children with B-lineage ALL 19 days after the beginning of remission induction therapy. In 211 patients (55.5 percent), the test determined that leukemic cells made up 0.01 percent or more of the cells in the sample. This result closely agreed with the results from the more expensive and complex tests, said Elaine Coustan-Smith, an associate scientist in the same departments and the paper's first author.

advertisement.gif (61x7 -- 0 bytes)
 

Are you a doctor or a nurse?

Do you want to join the Doctors Lounge online medical community?

Participate in editorial activities (publish, peer review, edit) and give a helping hand to the largest online community of patients.

Click on the link below to see the requirements:

Doctors Lounge Membership Application


The researchers reported that among the patients with 0.01 percent or more of leukemic cells detected by the simplified test on day 19, the incidence of relapse was about 29 percent after 10 years; among patients with levels of leukemic cells lower than 0.01 percent, the incidence of relapse was about 5 percent. The results obtained using the simplified test more accurately predicted whose disease would relapse and whose would respond well to chemotherapy than did standard risk factors, such as age and the presence of certain mutations in the cancer cells.

The St. Jude International Outreach Program (IOP) is now implementing this new test at a partner institution in Brazil, according to the paper's co-author, Raul Ribeiro, M.D., a member of the Department of Hematology-Oncology and IOP director. The pilot project in Recife, Brazil, aims to identify children who have MRD levels lower than 0.01 percent on day 19 so they can be treated with therapy that is less intense than the standard treatment. Previously, 10 percent of the children in Recife receiving standard therapy suffered fatal infections because of immune system suppression caused by the aggressive treatment, Ribeiro noted. Therefore, in addition to improving supportive care for patients, investigators in Recife sought to reduce the intensity of treatment for a select group of patients.

"Clinicians have known since the 1970s that about 40 percent of children with ALL can be cured with less intense therapy," Ribeiro said. "The problem is identifying those children who will be cured with less intense treatment so you can avoid or lessen the complications caused by aggressive therapy. The new MRD test developed at St. Jude can be used to identify patients who might be cured with less intensive treatment approaches. This will decrease the toxicity and the cost of treatment. Hence, we anticipate that the use of our new technique will increase the number of children who can be treated, and reduce the number of children who suffer fatal infections."

The other authors of the paper include Patricia Stow, Yinmei Zhou, Ching-Hon Pui and Gaston Rivera (St. Jude) and Francisco Pedrosa (Instituto Materno-Infantil de Pernambuco, Recife, Brazil).

Source

Blood.

 

 advertisement.gif (61x7 -- 0 bytes)

 

 



We subscribe to the HONcode principles of the HON Foundation. Click to verify.
We subscribe to the HONcode principles. Verify here

Privacy Statement | Terms & Conditions | Editorial Board | About us
Copyright 2001-2012 DoctorsLounge. All rights reserved.