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The cure rate for the once almost universally fatal childhood cancer acute lymphoblastic leukemia (ALL) could reach 90 percent in the near future, thanks to improvements in diagnosis and treatment over the past four decades, according to investigators at St. Jude Children’s Research Hospital. Almost 4,000 cases of ALL are diagnosed in the United States each year, about two-thirds of which are in children and adolescents, making this disease the most common cancer in this age group.
A report on the progress in the treatment of ALL authored by two St. Jude investigators appears in the January 12 issue of the New England Journal of Medicine.
Cancer is considered cured when a patient has been cancer free for 10 years. Currently the five-year survival rate for ALL at St. Jude has nearly reached 90 percent.
The progressive improvement in the cure rate since 1962, when only 4 percent of children with ALL survived, reflects in large part the more effective use of existing drugs and the incorporation of sophisticated genetic technologies to personalize treatments, the authors said. Research findings at St. Jude in particular have enabled clinicians to identify patients for whom standard treatment is most likely to fail, and who should therefore be treated more aggressively; these findings have also allowed clinicians to choose the optimal drugs and drug dosages for individual patients.
The improvements in ALL treatment are also helping to reduce the long-term toxic side effects of therapy by enabling clinicians to reduce or avoid the use of certain drugs or radiation that can damage major organs or cause secondary cancers.
“Our success reflects many years of dedication and research by an experienced team that has paid off substantially,” said Ching-Hon Pui, director of the Leukemia/Lymphoma Division at St. Jude and American Cancer Society F.M. Kirby Clinical Research Professor. “A 90 percent cure rate for ALL is quite possible in the near future if we continue to incorporate the breakthroughs of past decades and successfully overcome the remaining challenges.”
“The significant leadership role St. Jude played is due entirely to the enormous contributions made by our extraordinary team of doctors, pharmacists, nurses and other clinicians and scientists over the years,” said William E. Evans, Pharm.D., director and chief executive officer of St. Jude and the paper’s co-author. “Their efforts are directly responsible for helping to push up the cure rate for ALL.”
January 12, 2006