Outcome with Chemotherapy and Future Directions in Infant Acute Lymphoblastic Leukemia

• Published in: The Japanese Journal of Pediatric Hematology Vol. 18; no. 3; pp. 196 - 199
• Main Author: ISHII, Eiichi
• Format: Journal Article
• Language: Japanese
• Published: THE JAPANESE SOCIETY OF PEDIATRIC HEMATOLOGY/ONCOLOGY 2004; 特定非営利活動法人 日本小児血液・がん学会
• Subjects: chemotherapy; hematopoietic stem cell transplanta tion; infant acute lymphoblastic leukemia; MLL gene rearrangement
• ISSN: 0913-8706; 1884-4723
• DOI: 10.11412/jjph1987.18.196

In MLL96/MLL98 studies carried out between 1996 and 2002, the event-free survival for MLL-positive ALL infants improved with the combination of intensive chemotherapy and hematopoietic stem cell transplantation (HSCT). The effect of HSCT for MIL positive infant ALL can be predicted by several reasons as follows; the number of patients who relapsed immediately after induction therapy decreased, and the outcome of patients who received HSCT at first remission was superior, compared with that of those who received HSCT under other conditions. When all patients were classified into four subgroups according to age and white blood cell count at diagnosis, most of the patients under 6 months of age with high white blood cell count relapsed within a couple of months after the achievement of remission, suggesting that this patient group should be treated with HSCT. In contrast, it is possible that other groups can be cured with chemotherapy alone. In several studies of Western countries, the outcome of MLL-positive ALL infants has gradually improved with intensive chemotherapy. In our next study, the true risk factors of MLL-positive infant ALL should be clarified to introduce chemotherapy for this patient group to prevent early and late toxicities.