Treating childhood acute lymphoblastic leukemia without cranial irradiation.
Ching-Hon Pui,Dario Campana,Deqing Pei,W. Paul Bowman,John T. Sandlund,Sue C. Kaste,Raul C. Ribeiro,Jeffrey E. Rubnitz,Susana C. Raimondi,Mihaela Onciu,Elaine Coustan-Smith,Larry E. Kun,Sima Jeha,Cheng Cheng,Scott C. Howard,Vickey Simmons,Amy Bayles,Monika L. Metzger,James M. Boyett,Wing Leung,Rupert Handgretinger,James R. Downing,William E. Evans,Mary V. Relling +23 more
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TLDR
With effective risk-adjusted chemotherapy, prophylactic cranial irradiation can be safely omitted from the treatment of childhood ALL.Abstract:
Background Prophylactic cranial irradiation has been a standard treatment in children with acute lymphoblastic leukemia (ALL) who are at high risk for central nervous system (CNS) relapse. Methods We conducted a clinical trial to test whether prophylactic cranial irradiation could be omitted from treatment in all children with newly diagnosed ALL. A total of 498 patients who could be evaluated were enrolled. Treatment intensity was based on presenting features and the level of minimal residual disease after remission-induction treatment. The duration of continuous complete remission in the 71 patients who previously would have received prophylactic cranial irradiation was compared with that of 56 historical controls who received it. Results The 5-year event-free and overall survival probabilities for all 498 patients were 85.6% (95% confidence interval [CI], 79.9 to 91.3) and 93.5% (95% CI, 89.8 to 97.2), respectively. The 5-year cumulative risk of isolated CNS relapse was 2.7% (95% CI, 1.1 to 4.3), and t...read more
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Cancer treatment and survivorship statistics, 2012
Rebecca L. Siegel,Carol DeSantis,Katherine S. Virgo,Kevin Stein,Angela B. Mariotto,Tenbroeck Smith,Dexter L. Cooper,Ted Gansler,Catherine C. Lerro,Stacey A. Fedewa,Chun Chieh Lin,Corinne R. Leach,Rachel S. Cannady,Hyunsoon Cho,Steve Scoppa,Mark Hachey,Rebecca A. Kirch,Ahmedin Jemal,Elizabeth Ward +18 more
TL;DR: Common cancer treatments, survival rates, and posttreatment concerns are summarized and the new National Cancer Survivorship Resource Center is introduced, which has engaged more than 100 volunteer survivorship experts nationwide to develop tools for cancer survivors, caregivers, health care professionals, advocates, and policy makers.
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Acute Lymphoblastic Leukemia in Children
TL;DR: The most common cancer in childhood is now curable in 90% of patients and the subsets of acute lymphoblastic leukemia that are most resistant to current therapy are being targeted.
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Improved Survival for Children and Adolescents With Acute Lymphoblastic Leukemia Between 1990 and 2005: A Report From the Children's Oncology Group
Stephen P. Hunger,Xiaomin Lu,Meenakshi Devidas,Bruce M. Camitta,Paul S. Gaynon,Naomi J. Winick,Gregory H. Reaman,Gregory H. Reaman,William L. Carroll +8 more
TL;DR: This study documents ongoing survival improvements for children and adolescents with acute lymphoblastic leukemia, emphasizing that efforts to further improve survival must be directed at both high-risk subsets and at those children predicted to have an excellent chance for cure.
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Acute lymphoblastic leukaemia.
TL;DR: Genome-wide profiling of germline and leukaemic cell DNA has identified novel submicroscopic structural genetic changes and sequence mutations that contribute to leukaemogenesis, define new disease subtypes, affect responsiveness to treatment, and might provide novel prognostic markers and therapeutic targets for personalised medicine.
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Biology, Risk Stratification, and Therapy of Pediatric Acute Leukemias: An Update
TL;DR: The application of new high-throughput sequencing techniques to define the complete DNA sequence of leukemia and host normal cells and the development of new agents targeted to leukemogenic pathways promise to further improve outcome in the coming decade.
References
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Chronic Health Conditions in Adult Survivors of Childhood Cancer
Kevin C. Oeffinger,Ann C. Mertens,Charles A. Sklar,Toana Kawashima,Melissa M. Hudson,Anna T. Meadows,Debra L. Friedman,Neyssa Marina,Wendy L. Hobbie,Nina S. Kadan-Lottick,Cindy L. Schwartz,Wendy M. Leisenring,Leslie L. Robison +12 more
TL;DR: Survivors of childhood cancer have a high rate of illness owing to chronic health conditions, including severe, disabling, or life-threatening conditions or death due to a chronic condition.
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Treatment of acute lymphoblastic leukemia.
Ching-Hon Pui,William E. Evans +1 more
TL;DR: This review considers recent advances in the treatment of ALL, emphasizing issues that need to be addressed if treatment outcome is to improve further.
Journal ArticleDOI
Chronic Health Conditions in Adult Survivors of Childhood Cancer
TL;DR: Survivors of childhood cancer have a high rate of illness owing to chronic health conditions, particularly for severe, disabling, or life-threatening conditions or death due to a chronic condition.
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Medical assessment of adverse health outcomes in long-term survivors of childhood cancer
M.M. Geenen,Mathilde C. Cardous-Ubbink,Leontien C. M. Kremer,Cor van den Bos,Helena J H van der Pal,Richard C. Heinen,Monique W. M. Jaspers,Caro C.E. Koning,Foppe Oldenburger,Nelia E. Langeveld,Augustinus A. M. Hart,Piet J. M. Bakker,Huib N. Caron,Flora E. van Leeuwen +13 more
TL;DR: In young adulthood, a substantial proportion of childhood cancer survivors already has a high or severe burden of disease, particularly after radiotherapy, which underscores the need for lifelong risk-stratified medical surveillance of Childhood cancer survivors.
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Moving towards individualized medicine with pharmacogenomics
TL;DR: The intersection of genomics and medicine has the potential to yield a new set of molecular diagnostic tools that can be used to individualize and optimize drug therapy.
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