Comprehensive gene profiles hold promise for improving outcome of pediatric leukemia

(MEMPHIS, TENN.--October 31 , 2003) Investigators at St. Jude Children's Research Hospital have identified the genetic fingerprints of the major subtypes of pediatric acute lymphoblastic leukemia (ALL), the most commonly treated pediatric cancer. The achievement promises to enhance the ability of physicians to more accurately diagnose ALL, improve their ability to accurately monitor a patient's response to therapy, and eventually, develop more effective and less-toxic drugs to treat this cancer.

The findings will also provide an invaluable resource for exploring the biological events that turn normal white blood cells into leukemic cells, according to James Downing, M.D., chair of the St. Jude department of Pathology. Downing is senior author of a report on this work, which appears in the October issue of Blood.

"Our ability to genetically fingerprint the different subtypes of ALL is extremely important," Downing said. "The only way to know how aggressively to treat a specific patient is to know which subtype of ALL the child has, since each subtype has a different prognosis."

The current work by the St. Jude team builds on work they previously published in 2002. In that study, the team used a single gene chip to identify the known subtypes of ALL. The current study used much higher density gene chips, which provided nearly complete coverage of the human genome. As a result, almost 60 percent of the ALL genes identified in the present study are new.

Pediatric ALL is one of the great success stories of modern cancer therapies, with overall event-free survival rates approaching 80 percent, according to Downing. Part of this success is due to the realization by researchers that there are different subtypes of ALL, each of which must be treated with a different level of intensity. This so-called risk-adapted therapy depends on accurately defining a patient's relative risk of relapse following treatment, and doing so before treatment begins. <

Contact: Bonnie Cameron
St. Jude Children's Research Hospital

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