Physicians have better insight on treating patients with Philadelphia chromosome-positive acute lymphoblastic leukemia

St. Jude Children's Research Hospital (ALSAC)
Thursday, 6 April 2000

International study concludes matched-siblings bone marrow transplant most effective treatment

(Memphis, Tennessee, April 6, 2000) Physicians now have a clear direction in treating patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph-positive ALL), as reported in a new study published in the April 6 issue of the New England Journal of Medicine. St. Jude Children's Research Hospital investigator Ching-Hon Pui, M.D. is one of the authors of the study.

The survival rate for children with ALL, the most common form of childhood cancer, ranges from 75 to 80 percent. Ph-positive ALL, is a specific type of ALL that has an overall poor prognosis. There has been no true consensus on how to treat this type of leukemia until now.

"The main objectives of this international study were to identify subgroups of Ph-positive patients with different prognosis and to assess the effect of different post-remission therapies on event-free and overall survival," said Pui.

The study involved 326 children and young adults, ages 4 months to 19 years of age, with Ph-positive ALL treated by 10 national collaborative groups or institutions. The research concluded that bone marrow transplant with a matched sibling donor is the best possible treatment for these patients regardless of prognosis.

"A third of patients with Ph-positive ALL have relatively a good prognosis and can potentially be cured with conventional chemotherapy," said Pui. "These patients should not be subjected to high-risk bone marrow transplant if a matched sibling donor is not available."

Many patients who are eligible for bone marrow transplantation lack a matched sibling donor forcing physicians to consider alternatives. Through this study researchers found transplantation of marrow from a mismatched related donor or of autologous marrow was not superior to chemotherapy.

Over the last two years, the study authors reviewed, analyzed and compiled data from patients with Ph-positive ALL treated in the United States and Western Europe over a 10 year period from 1986-1996.

St. Jude Children's Research Hospital, located in Memphis, Tennessee, was founded by the late entertainer Danny Thomas. The hospital is an internationally recognized biomedical research center dedicated to finding cures for catastrophic diseases from childhood. The hospital's work is supported through funds raised by the American Lebanese Syrian Associated Charities (ALSAC). All St. Jude patients are treated regardless of their ability to pay. ALSAC/St. Jude covers all costs of treatment beyond those reimbursed by third party insurers, and total costs for families who have no insurance.

For more information, or to contact St. Jude Children's Research Hospital (ALSAC), see their website at: www.stjude.org