Leukaemia survivors reassured

Most people who survive a common form of childhood cancer are likely to have a normal lifespan, according to the latest figures. Acute Lymphoblastic Leukaemia (ALL) accounts for approximately a third of all childhood cancers in the UK.

Cure rates are now high, but there were concerns about the quality of life of children who beat the disease. However, a study in the New England Journal of Medicine suggests that they have the potential to have a normal adulthood. Marriage and employment rates for most of the leukaemia survivors was broadly the same as for the general population. The only patients who had a slight increase in death rate later in life were those who were given radiotherapy to the brain as part of their treatment. This is still occasionally required as part of modern treatments – but the standard treatment involves only chemotherapy. The risk increased because the radiation led to a small increase in the chance of the development of a “secondary” cancer unrelated to the leukaemia. The study was carried out at St Jude Children’s Research Hospital in Memphis, Tennessee, and looked at 856 patients treated between 1962 and 1992. It focused on patients who had been “cured” – that is, free of the original disease for at least 10 years. At this point, doctors can be relatively sure that the leukaemia has been dealt with. RelapsesOf the 856 patients, 56 had what were described as “major adverse events” – including four relapses of the orignal cancer and 44 secondary cancers. Of the secondaries, 41 were related to radiotherapy, and most were benign growths or non-agressive cancers. Dr Melissa Hudson, who carried out the study, said: “The good news is that ALL patients who did not receive radiation therapy and achieved 10 years or more of survival after treatment without a significant problem can look forward to a normal extended survival. “Patients who had received radiation need long-term monitoring for early diagnosis and treatment of secondary tumours. “Fortunately, most of these are low grade in malignancy and can be cured readily.” Approximately 400 cases of “acute” childhood leukaemia are diagnosed each year in the UK – 350 of these are ALL. ALL is more common in male children, and the risk is highest between the ages of two and five. The causes of the disease are still unclear, although as the cancer affects key immune cells, it has been suggested that an abnormal immune response, triggered by an unknown factor, is to blame. (Source: BBC, Thursday, 14 August, 2003, 09:36 GMT 10:36 UK)