Acute lymphoblastic leukemia

Dana-Farber/Children’s Hospital Cancer Center is home to New England’s most active pediatric oncology clinical research program. We are:

• founders of the Dana-Farber Cancer Institute ALL Consortium, internationally recognized as a leader in the treatment of childhood ALL
   
• the region’s Phase I referral center for testing new drugs for the Children’s Oncology Group
   
• focused on improving cure rates by developing new tests to identify subtypes of leukemia that may need different therapies, and also by developing and testing new types of treatments
   
• focused on reducing the toxicity of and late-effects related to chemotherapy and radiation therapy

What is the latest research on ALL?

Our researchers are conducting randomized clinical studies in childhood. The goal is to reduce treatment intensity for leukemia with good outcomes (to avoid side effects) and to test more intense and newer therapies for subtypes with poorer outcomes (to improve cure rates). DF/CHCC is recognized as an international leader in the treatment of this disease. Our clinicians design and use their own protocols and have reported the best cure rates for this disease yet published.

Research activities

Recent examples of these accomplishments include:

• As part of our clinical trials, we identified that minimal residual disease levels (measuring leukemia cells that cannot be seen under a microscope using a special test) can predict risk of relapse and be used to determine treatment.
   
• Our researchers have identified potential new therapies using gene expression based high-throughput screening, a new method for drug discovery pioneered in our laboratories.
   
• In the lab, we’ve developed new genetic models of T-cell ALL and lymphoblastic lymphoma to test new treatments.
   
• Our research scientists determined the mechanisms of leukemia cell resistance to various chemotherapeutic agents, with a focus on identifying agents to reverse overcome drug resistance.
   
• Our clinical trials demonstrated that a drug called dexrazoxane could prevent heart problems in children treated for ALL.
   
• We’ve initiated new, early-phase trials based on results from our laboratories.

The Dana-Farber Cancer Institute ALL Consortium

The Dana-Farber Cancer Institute ALL Consortium, headed by Drs. Lewis Silverman and Stephen Sallan (physicians at Boston Children's Hospital and the Dana-Farber Cancer Institute) is an international leader in ALL treatment and research, including:

• treatment protocol design and outcome
   
• using advanced laboratory technology to characterize leukemia in order to identify subsets of ALL that may require different therapy
   
• identifying and reducing the risk of neuropsychologic late effects (for example, learning problems) in survivors of childhood ALL
   
• identifying and reducing the risk of heart problems in survivors of childhood ALL
   
• identifying and reducing the risk of side effects from chemotherapeutic agents used to treat ALL, including asparaginase and steroids
   
• ongoing assessment of patients' quality-of-life during after therapy
   
• trials of novel treatments for relapsed and refractory ALL uniquely available at Dana Farber/Children’s Hospital Cancer Center

Children’s Oncology Group

In addition, we are members of the Children's Oncology Group, which allows us to provide our patients with:

• investigational drugs for children with relapsed, refractory ALL available only via the Children's Oncology Group
   
• Children's Oncology Group studies for treatment of patients with relapsed disease