Acute Lymphocytic Leukemia Health Article

Clinical trials

There are numerous clinical trials looking at novel strategies for the treatment of ALL in adults and children. Most oncologists consider bone marrow transplants to be state-of-the-art in specific circumstances, and some insurance companies agree. Many still require extensive reviews before approving coverage for transplant.

A variety of biological agents are currently under study. These include antibodies that react specifically against leukemic cells, causing their death, and chemicals that interfere with the leukemic cells' normal DNA function or their ability to make proteins.

Researchers are developing second and third generation versions of established chemotherapeutic drugs, isolating the molecular components of those drugs that seem to be most useful in ALL and amplifying them. Some of these drugs include 9-aminocamptothecin, aminopterin, annamycin, Ara-G, codrycepin, decitabine, and trimetrexate. Quinine shows promise in reducing the incidence of drug resistance that is sometimes seen in leukemic cells.

Locating and enrolling in clinical trials has been made easier by listings on the Internet. A general search under "clinical trials and leukemia" will yield several listings. University-affiliated hospitals and oncologists participate in many trials and can refer patients to other sites if necessary.

Prevention

There are few preventive measures to take against ALL. Those who work with chemicals should be cautious, particularly around benzene. Pregnant women should avoid exposure to ionizing radiation to reduce the risk to their unborn children.

Special concerns

Parents of children with ALL have specific concerns regarding the long-term consequences of treatment for ALL, such as learning disabilities. Organizations devoted to childhood cancer, hospital social workers, pediatric oncologists and other parents can be important resources when advocating for the educational needs of the child with ALL.

When cranial radiation must be used, children have a risk of developing secondary cancers in the central nervous system years later. Some children are left infertile by the treatment. Chicken pox can be lethal in children with ALL. The introduction of the chicken pox vaccine has reduced this risk, but parents must still be vigilant.

Resources

BOOKS

Lackritz, Barb. Adult Leukemia: A Comprehensive Guide for Patients and Families. Sebastopol, CA: O'Reilly & Associates, 2001.

Keene, Nancy, and Linda Lamb. Childhood Leukemia: A Guide for Families, Friends & Caregivers. Sebastopol, CA: O'Reilly & Associates, 1999.

Laszlo, John, M.D. The Cure of Childhood Leukemia: Into the Age of Miracles. New Brunswick: Rutgers University Press, 1995.

McKay, Judith, and Nancee Hirano. The Chemotherapy and Radiation Therapy Survival Guide. Oakland: New Harbinger Publications, 1998.

Patenande, Robert. Surviving Leukemia: A Practical Guide. Quebec: Firefly Books, Ltd., 1999.

PERIODICALS

Gaynon, P.S., et al. "Children's Cancer Group Trials in Childhood Acute Lymphoblastic Leukemia: 1983-1995." Leukemia 14, no. 5 (December 2000): 2223-33.

Greaves, M.F. "Aetiology of Acute Leukaemia." The Lancet349, no. 9048 (February 1997): 344-9.

Hasle, H., et al. "Risks of Leukaemia and Solid Tumours in Individuals with Down Syndrome." The Lancet 355, no. 9199 (January 2000): 165-9.

Pui, C.H. "Acute Lymphoblastic Leukemia in Children." Current Opinions in Oncology 12, no. 1 (January 2000): 3-12. Weisdorf, D.J. "Bone Marrow Transplantation for Acute Lymphoblastic Leukemia (ALL)." Leukemia 11, Supp. 4 (May 1997): 420-2.

ORGANIZATIONS

The Leukemia and Lymphoma Society of America (formerly The Leukemia Society of America). 1311 Mamaroneck Ave., White Plains, NY 10605. (914) 949-5213. <http://www.leukemia-lymphoma.org>.

American Cancer Society. 1599 Clifton Rd., Atlanta, GA, 30329. (800) ACS-2345. <http://www.cancer.org>.

The National Cancer Institute. Cancer Information Service. Building 31, Room 10A31, 31 Center Dr., MSC 2580, Bethesda, MD 20892-2580. (301) 435-3848. <http://www.nci.nih.gov/>

Cancer Care, Inc. 1180 Avenue of the Americas, New York, NY10036. (212) 302-2400 or (800) 813-4673. <http://www.cancercare.org>

National Marrow Donor Program. Suite 500, 3001 Broadway St. NE, Minneapolis, MN 55413-1753. (800) MARROW-2. <http://www.marrow.org/>

Candlelighters Childhood Cancer Foundation. 7910 Woodmont Ave., Suite 460, Bethesda, MD 20814. (800) 366-CCCF. <http://www.candlelighters.org>

National Childhood Cancer Foundation. 440 E. Huntington Dr., P.O. Box 60012, Arcadia, CA 91066-6012. (626) 447-1674. <http://www.nccf.org>

OTHER

PDQ (Physician Data Query). (800) 4-CANCER. 9 July 2001<http://cancernet.nci.nih.gov>

Granny Barb and Art's Leukemia Links. 9 July 2001 <http://www.acor.org/diseases/hematology/Leukemia/leukmain.html>

National Children's Cancer Society. 9 July 2001 <http://www.children-cancer.com>

Patient-centered Guides. <http://www.patientcenters.com/leukemia>

CancerNet Clinical Trials Listings. 9 July 2001 <http://www.cancernet.nci.nih.gov/index.html>

Veritas A service of Harvard Medical School, listing clinical trials throughout the US. 9 July 2001 <http://www.veritasmedicine.com/leukemia>

International clinical trials listings. 9 July 2001 <http://www.graylab.ac.uk/cancerweb/trials.html>

Why, Charlie Brown, Why? Videotape. Topper Books, 1990.

Marianne Vahey, M.D.

KEY TERMS

Antiangiogenic drugs —Drugs that block the formation of new blood vessels.

Blasts

—Immature blood cells.

CBC

—Complete blood count, a blood test that measures red cells, white cells and platelets.

Graft versus host disease

—After bone marrow transplant, the newly transplanted white blood cells can attack the patient's own tissues.

Intrathecal chemotherapy

—Chemotherapeutic drugs instilled directly into the spinal fluid, either by spinal tap or through a special reservoir.

Karyotype

—The number and type of chromosomes found within cells.