Full Answer
Is a pediatric lymphoblastic leukemia regimen best for older adolescents?
Retrospective studies have suggested that older adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL) have better survival rates when treated using a pediatric ALL regimen administered by pediatric treatment teams. To address the feasibility and efficacy of using a pediatric tr …
Is there a new treatment standard for acute myeloid leukemia (Aya)?
CALGB 10403 can be considered a new treatment standard upon which to build for improving survival for AYAs with ALL. This trial was registered at www.clinicaltrials.gov as #NCT00558519. © 2019 by The American Society of Hematology.
Is there a new treatment standard for Ayas with all?
CALGB 10403 can be considered a new treatment standard upon which to build for improving survival for AYAs with ALL. This trial was registered at www.clinicaltrials.gov as #NCT00558519. © 2019 by The American Society of Hematology. Publication types Clinical Trial Research Support, N.I.H., Extramural
What is the treatment for B-lineage acute lymphoblastic leukemia (Alb)?
Thomas DA, O’Brien S, Faderl S, et al. . Chemoimmunotherapy with a modified hyper-CVAD and rituximab regimen improves outcome in de novo Philadelphia chromosome-negative precursor B-lineage acute lymphoblastic leukemia. J Clin Oncol. 2010;28(24):3880-3889.
What is the Calgb 10403 regimen?
CALGB 10403 treatment consisted of induction, consolidation, interim maintenance, delayed intensification, and long-term maintenance therapy (detailed dosing schedule provided in Figure 1) and replicated exactly 1 arm of the Children's Oncology Group (COG) randomized study AALL0232 for high-risk childhood ALL.
What is the most effective treatment for acute lymphoblastic leukemia?
The main treatment for acute lymphocytic leukemia (ALL) in adults is typically long-term chemotherapy (chemo)....Different combinations of chemo drugs might be used, but they typically include:Vincristine.Dexamethasone or prednisone.An anthracycline drug such as doxorubicin (Adriamycin) or daunorubicin.
Which drug is used in treatment of lymphoblastic Leukaemia in children?
The most commonly used chemo drugs are vincristine, L-asparaginase, anthracyclines (doxorubicin, daunorubicin, or mitoxantrone), cyclophosphamide, cytarabine (ara-C), and either etoposide or teniposide. The child will also receive a steroid (prednisone or dexamethasone). Intrathecal chemo will also be given.
What are the recent advances in the treatment of leukemia?
New Chemotherapy Drugs Chemotherapy treats many types of cancer, including leukemia. New types of chemotherapy are better at targeting leukemia cells. Drugs that doctors are currently testing as a treatment for acute myeloid leukemia (AML) include tipifarnib, bortezomib, sapacitabine and laromustine.
What is the main treatment for most childhood leukemia?
The main treatment for most childhood leukemias is chemotherapy. For some children with higher risk leukemias, high-dose chemotherapy may be given along with a stem cell transplant. Other treatments might also be used in special circumstances.
What are treatment options for acute lymphocytic leukemia?
Depending on your situation, the phases of treatment for acute lymphocytic leukemia can span two to three years. Treatments may include: Chemotherapy. Chemotherapy, which uses drugs to kill cancer cells, is typically used as an induction therapy for children and adults with acute lymphocytic leukemia.
What is the best medicine for leukemia?
A medicine called imatinib is now the main treatment for CML. It's usually given soon after a diagnosis is made to slow the progression of the cancer and stop it reaching an advanced phase. Imatinib works by reducing the production of abnormal white blood cells. It's taken as a tablet once a day.
What is 6 mercaptopurine used for?
MERCAPTOPURINE, 6-MP (mer kap toe PYOOR een) is a chemotherapy drug. It interferes with the growth of cancer cells and can reduce immune system activity. It is used to treat certain types of acute leukemia.
What cyclophosphamide is used for?
Cyclophosphamide is used to treat cancer of the ovaries, breast, blood and lymph system, and nerves (mainly in children). Cyclophosphamide is also used for retinoblastoma (a type of eye cancer mainly in children), multiple myeloma (cancer in the bone marrow), and mycosis fungoides (tumors on the skin).
Has leukemia treatment improved?
In 2018, a large clinical trial showed that adding the drug nelarabine (Arranon) to standard chemotherapy improves survival for children and young adults newly diagnosed with T-cell ALL. Other drugs are being tested that may make standard chemotherapy drugs more effective.
Does Immunotherapy work for leukemia?
Immunotherapy is a promising option for treating leukemia, although many types of immunotherapy are experimental and only available through clinical trials. Immunotherapy may also be effective in combination with chemotherapy.
What is one of the newest forms of treatment for leukemia Mcq?
What is one of the newest forms of treatment for leukemia? Explanation: Stem cell transplantation is the newest treatment for leukemia.
Does AYA have minimal residual disease?
As in previous trials, the researchers found that patients who had no detectable cancer cells (known as minimal residual disease) after induction chemotherapy had excellent survival rates. In the current study, however, a smaller percentage of AYA patients had no minimal residual disease, compared with previous trials involving children with ALL.
Who was the first patient treated on CalGB 10403?
Jenn Ferguson (left), one of the first patients treated on the CALGB 10403 trial, and Wendy Stock, M.D. During treatment, Ferguson continued her education and went on to earn a professional degree, marry, and become a proud mother of two.
Is ALL effective for AYA?
An intensive treatment regimen developed specifically for children with acute lymphoblastic leukemia (ALL) is also effective for older adolescents and young adults (AYAs) with the disease, according to new results from a clinical trial. In the trial, the use of an intensive pediatric treatment regimen led to better outcomes for AYA patients ...
Survival differences among pediatric and AYA patients
In explaining the motivation behind this research, Cleveland Clinic pediatric oncologist Stefanie Thomas, MD, says that the oncology community has been puzzled for a while by the decreased improvements in survival in patients with ALL between the ages of 15 and 39 compared with younger children.
Extending the pediatric-inspired regimen to AYAs
This study aimed to take a deeper look into the toxicities of the pediatric-inspired regimen in AYAs and to assess the overall tolerability of the regimen, as well as the feasibility of extending it to this older population.
Factors influencing treatment completion
A somewhat unexpected finding was that only 39% of patients in the CALGB study completed all planned protocol treatment. In the COG AALL02332 trial 57% of patients older than or equal to 18 years of age completed treatment, compared to 74% of patients younger than 18 years who completed treatment.
Abstract
Studies have demonstrated superior outcomes for adolescent and young adult (AYA) patients with acute lymphoblastic leukemia (ALL) who are treated using pediatric versus adult therapeutic regimens. To the best of our knowledge, whether adult oncologists in the United States have adopted this approach to ALL in AYA patients is currently unknown.
INTRODUCTION
Over the past decade, a large body of research has focused on discrepancies in the treatment approach and survival of adolescent and young adult (AYA) patients with acute lymphoblastic leukemia (ALL) treated in the pediatric versus adult setting.
MATERIALS AND METHODS
Data were abstracted from the population-based Greater Bay Area Cancer Registry (GBACR), a division of the California Cancer Registry (CCR) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program.
RESULTS
For the youngest AYA patients (those aged 15-18 years), the majority received therapy in a pediatric setting (93%), with no significant changes in treatment setting noted over time (Fig. 2 ). Older AYA patients (those aged 25-39 years) were exclusively treated in adult settings throughout the decade.
DISCUSSION
AYA patients with ALL represent a unique population at a crossroads between pediatric and adult oncology.
FUNDING SUPPORT
Supported by the Stanford Cancer Institute (to Scarlett Lin Gomez) and the National Cancer Institute's Surveillance, Epidemiology, and End Results Program under contract HHSN261201000140C (to Daphne Lichtensztajn).
AUTHOR CONTRIBUTIONS
Lori Muffly: Designed concept and study, acquired data, performed analyses, wrote and edited the article, and was responsible for overall content. Daphne Lichtensztajn: Designed concept and study, acquired data, performed analyses, and edited the article.
Testing An Intensive Therapy in Aya Patients
Predicting The Response to Therapy
- Patients in the study who were obese, “and particularly those who were very obese, had worse outcomes than other patients,” Dr. Stock said. Nearly a third of the patients in the trial had a body mass indexof 30 or higher, which is considered obese. “The impact of obesity on the outcomes of patients was dramatic,” Dr. Stock added, noting that more research is needed to understand the …
Building on The Current Regimen
- As in previous trials, the researchers found that patients who had no detectable cancer cells (known as minimal residual disease)after induction chemotherapy had excellent survival rates. In the current study, however, a smaller percentage of AYA patients had no minimal residual disease, compared with previous trials involving children with ALL. The higher incidence of the Philadelph…
Increasing Awareness Among Physicians
- Preliminary results from the trial have been presented at scientific meetings in the past, so many pediatric oncologists are aware of the work, though some medical oncologists in community settings may not be familiar with the findings, Dr. Seibel said. “We’ve been waiting for the final results,” she continued. “It’s important to make sure that medical oncologists are aware of this s…