News Release

St. Jude leukemia therapy overcomes differences in treatment outcome between black, white children

St. Jude study comparing long-term outcomes of children treated for acute lymphoblastic leukemia shows that black children can do as well as white children if given equal access to latest treatments

Peer-Reviewed Publication

St. Jude Children's Research Hospital

(MEMPHIS, TENN.--October 14, 2003) Investigators at St. Jude Children's Research Hospital have found that black children are equally likely as white children to benefit from improved treatment for acute lymphoblastic leukemia (ALL), if given equal access to the most advanced therapies.

This finding--that black and white children had virtually equal rates of survival over 10 years--contrasts with the results of clinical studies from the Pediatric Oncology Group (POG) and Children's Cancer Group (CCG). The POG and CCG multi-center studies showed that black children lagged behind white children in the cure rate for ALL.

Even though black children referred to St. Jude were more likely to have high-risk leukemia and be socioeconomically underprivileged, they enjoyed the same excellent treatment results as white children, according to Ching-Hon Pui, M.D., director of the St. Jude Leukemia/Lymphoma division.

Pui is senior author of this study, which appears in the Oct. 15 issue of the Journal of the American Medical Association. Despite black children presenting with more bulky disease at diagnosis and having unfavorable genetic subtypes of leukemia, the St. Jude treatment was able to achieve high cure rates that were equal in black and white children.

"It's remarkable that, although African-American children with ALL are more likely than white children to have high-risk leukemia, the black children in our studies derived as much benefit from therapy as white children," said William Evans, Pharm.D., St. Jude scientific director and a co-author of the study. "This is apparently due to the modifications we made to our previous, very successful therapies for ALL, making those treatments even more effective."

One factor contributing to the treatment success rate among black children is that all St. Jude patients received a personally tailored approached to treatment--called risk-directed therapy--regardless of health insurance status or ability to pay. The study included 68 black children and 338 white children with newly diagnosed ALL. The patients were enrolled in clinical trials and received the same induction treatment until the leukemia was in remission. For the next 120 weeks, the children received "risk-directed, post-remission therapy."

This post-remission therapy varied depending on whether the child was considered at low risk or high risk for recurrence of the cancer. Children considered at low risk received less aggressive therapy during this time than did those considered at high risk. The St. Jude team used strict criteria to classify patients according to their risk of failing therapy, which led them to assign more than three-fourths of the black children to risk groups that received intensified therapy, according to Pui.

At the end of 10 years the survival rates were 86.2 percent (±18.5 percent) for black children and 80.3 percent (±6.6 percent) for white children. In addition, the rate of event-free survival (no recurrence of cancer) was 74.8 percent (±26.5 percent) for black children and 73.6 percent (±7.6 percent) for white children.

"The results of our clinical study show that effective treatment as provided at St. Jude can overcome the risk factors that so often lead to treatment failure--especially in black children," Pui said.

Other authors of this study are John T. Sandlund, M.D.; Deqing Pei; Gaston K. Rivera, M.D.; Scott C. Howard, M.D.; Raul C. Ribeiro, M.D.; Jeffrey E. Rubnitz, M.D., Ph.D.; Bassem I. Razzouk, M.D.; Melissa Hudson, M.D.; Cheng Cheng, Ph.D.; Susana C. Raimondi, Ph.D.; Frederick G. Behm, M.D.; James Downing, M.D.; and Mary V. Relling, Pharm.D.--all of St. Jude Children's Research Hospital.

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About St. Jude Children's Research Hospital
St. Jude Children's Research Hospital is internationally recognized for its pioneering work in finding cures and saving children with cancer and other catastrophic diseases. Founded by late entertainer Danny Thomas and based in Memphis, Tenn., St. Jude freely shares its discoveries with scientific and medical communities around the world. No family ever pays for treatments not covered by insurance, and families without insurance are never asked to pay. St. Jude is financially supported by ALSAC, its fundraising organization. For more information, please visit www.stjude.org.


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