Dr. William Carroll, a researcher at NYU Langone Medical Center, said a recent study he led shows new protocols using higher doses of a standard chemotherapy drug and steroid for younger patients can improve relapse rates for patients with acute lymphoblastic leukemia. Photo by NYU Langone Medical Center
NEW YORK, April 25 (UPI) -- Researchers found relapse rates for the most common form of leukemia in children, which is largely considered curable, can be lowered with higher doses of a common chemotherapy drug, according to a recent study.
Researchers at New York University Langone Medical Center found giving acute lymphoblastic leukemia patients additional treatment with a chemotherapy drug and steroid helped lower the number of relapses.
About 90 percent of patients with ALL are cured, though about 20 percent of patients with the highest risk of relapse are not cured.
The method researchers investigated -- using escalating higher doses of the drug methotrexate to prevent relapse -- was effective, with the addition of the steroid decadron helping prevent relapse in spinal fluid and bone marrow in patients under age 10.
"The improvement in cure rates for ALL over the last few decades, for the most part, has not come through the introduction of new medications, but through using existing medications in new ways, in terms of their dose and schedule," Dr. William Carroll, director emeritus of the Perlmutter Cancer Center at New York University, said in a press release.
For the study, published in the Journal of Clinical Oncology, the researchers recruited 2,914 patients between 2004 and 2011 between ages 1 and 30, randomly assigned patients to receive dexamethasone for 14 days or prednisone for 28 days and either high-dose methotrexate or an escalating dose of methotrexate.
Although all patients saw lower rates of relapse, patients given the high dose the entire trial did better. In the case of the steroid, only children under age 10 had a response to dexamethasone, which researchers say suggests it should not be used with older children, potentially sparing them the side effects.
"This clinical trial illustrates that despite what seem to be remarkable outcomes for kids with ALL, we have not reached a plateau," Carroll said. "The outcomes are getting better and better."