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Personalised leukaemia treatment in children

03 August 2012

Mrs Amy Liew and husband Joshua were thankful that their young daughter was treated with the new procedure by Assoc Prof Quah Thuan Chong (2nd from right), Head of NUH's Division of Paediatric Haematology-Oncology. Assoc Prof Yeoh (right) notes that most patients studied responded well to lower-intensity chemotherapy

A six-year study by Singaporean and Malaysian specialists and doctors found a personalised treatment protocol that alleviates young leukaemia patients' organ damage and improves their quality of life. The study was published in the leading Journal of Clinical Oncology in July.

Principal investigator Associate Professor Allen Yeoh, who is with the NUS Yong Loo Lin School of Medicine's Department of Paediatrics, said that out of the 556 children aged below 18 years old who were recruited for the study, 86 per cent were found to require a significantly lower dose of chemotherapy without compromising their long-term cure rate.

The children were from four centres in Singapore and Malaysia - National University Hospital (NUH), KK Women's and Children's Hospital, University of Malaya Medical Centre and Sime Darby Medical Centre in Subang Jaya.

Childhood acute lymphoblastic leukaemia is the most common form of cancer in children. It is highly curable with intensive chemotherapy, but the treatment can damage organs and lead to complications such as secondary cancers.

The NUH team came up with a cost-effective method to accurately measure the young patient's response to treatment, using less intense chemotherapy for the majority of the children. They apply the most intense regimen only for those with poor response and had the highest risk of recurrence.

The new approach lowered the intensity of the treatment by 25 per cent, compared to the conventional protocol prescribed in most developed countries. Most of the patients in the study could be out of the hospital and managed as outpatients within five days from diagnosis, compared to the usual one month.

"By personalising the dose of the chemotherapy drugs, we were able to deliver the optimal doses to maximise each child's potential for cure," said Assoc Prof Yeoh, who is also Senior Consultant at NUH's Division of Paediatrics Haematology-Oncology and the National University Cancer Institute, Singapore.

The study was made possible by funding from the Singapore Ministry of Health's National Medical Research Council, Agency for Science, Technology and Research, Cancer Science Institute (Singapore), Children's Cancer Foundation and Viva Foundation for Children with Cancer.

The doctors have embarked on a new study to further investigate how to tailor and optimise treatment results for every young patient.