Studying Childhood ALL Relapse and Survival
Name of the Trial
Study of Adherence to Long-Term Maintenance Mercaptopurine Therapy in Younger Patients With Acute Lymphoblastic Leukemia in First Remission (COG-AALL03N1). See the protocol summary.
Dr. Smita Bhatia, Children's Oncology Group.
Why This Trial Is Important
Acute lymphoblastic leukemia (ALL) is the most common childhood cancer in the United States. Though once considered universally fatal, childhood ALL can now be cured in approximately 80 percent of patients.
While the rates of disease remission following initial treatment are similar for children of various racial and ethnic groups, the rates of relapse and survival differ. Asian children have the best survival and African-American children the worst. Survival rates for white and Hispanic children fall between these extremes.
In this study, researchers will monitor patients in these groups to see if differences can be found in disease biology, in the way cancer-fighting medications (in particular, mercaptopurine) are metabolized by the body, and in adherence to prescribed long-term medication dosing and schedule. Blood samples will be taken to determine how children in the different groups metabolize mercaptopurine, since differences in drug metabolism may contribute to the dissimilarity in survival rates. In addition, an electronic pill-monitoring system and adherence questionnaires will be used throughout the study to determine if there are differences in adherence behavior.
"It is very important to understand why differences in relapse and survival exist, so we can initiate interventions to mitigate these differences," said Dr. Bhatia. "If effective interventions can be developed, survival for Hispanic and African-American children could potentially improve by 10 to 15 percent."
Who Can Join This Trial
This study is being conducted at Children's Oncology Group member institutions. For more information, see the study contact information or call the NCI Cancer Information Service at 1-800-4-CANCER (1-800-422-6237). The toll-free call is confidential.