Children can be treated for a common form of childhood leukemia without bombarding the brain with radiation, reducing the risk that they will suffer additional tumors and thinking problems, US researchers said on Wednesday. They said chemotherapy injected into the blood and the fluid that bathes the brain and spinal cord produced results that were just as good. “We believe children with ALL (acute lymphoblastic leukemia) do not need to get cranial irradiation preventively, which is different from what some centers recommend,” Mary Relling of St. Jude Children's Research Hospital in Memphis, who worked on the study. Radiation was once a routine therapy for ALL, the most common form of childhood cancer. But the treatment can cause second cancers, stunted growth, hormone imbalances and cognitive deficits. In the new study, Relling and colleagues found 86 percent of the 498 children given aggressive chemotherapy survived, cancer-free, for five years. Among 71 patients who normally would have received brain irradiation in the past, the five-year survival rate was 91 percent, much better than a comparison group consisting of children who had previously received the radiation therapy for their ALL. For them, the survival rate was 73 percent. “These are the best results reported to date,” Relling said. The amount of chemotherapy was personalized for each child, depending in part on how many leukemia cells were detected after initial treatment. Acute lymphoblastic leukemia is a cancer of the white blood cells, the cells in the body that normally fight infections.
