Toward the Cure of Acute Lymphoblastic Leukemia in Children in China

Abstract

This study explored results of therapy of children with acute lymphoblastic leukemia (ALL) in China, recent progress, and challenges. Included are a survey of therapy outcomes of ALL in Chinese children nationwide, comparison of these data with global ALL therapy outcomes, analyses of obstacles to improving outcomes, and suggestions of how progress can be achieved. Therapy outcomes at many Chinese pediatric cancer centers are approaching those of resource-rich countries. However, nationwide outcomes still need improvement. Obstacles include suboptimal clinical trials participation, children without adequate health care funding, human resource shortages, especially physicians expert in pediatric hematology and oncology, and social-economic disparities. We suggest how these obstacles have been and continue to be remedied including expanded access to protocol-based therapy, improved supportive care, health care reforms, recruitment of trained personnel, and international collaborations. China has made substantial progress treating children with ALL. We envision even better outcomes in the near future.

CD19/CD20 dual-targeted chimeric antigen receptor-engineered natural killer cells exhibit improved cytotoxicity against acute lymphoblastic leukemia

“…Acute Lymphoblastic Leukemia (ALL) is a hematological tumor arising from lymphoid progenitor cells of B-lineage or T-lineage [ 1 ], which due to abnormal growth of CD19 + precursor B cells and subsequent inhibition of normal hematopoiesis, resulting in anemia, thrombocytopenia, and neutropenia [ 2 ]. The peak incidence of ALL is between ages 2–5 in children [ 3 ], with 10% to 15% experiencing relapse despite achieving remission after first-line chemotherapy [ 4 – 6 ]. Refractory and relapse ALL (R/R-ALL) patients face a dismal prognosis with a 5-year overall survival rate below 20% [ 6 ].…”

“…The peak incidence of ALL is between ages 2–5 in children [ 3 ], with 10% to 15% experiencing relapse despite achieving remission after first-line chemotherapy [ 4 – 6 ]. Refractory and relapse ALL (R/R-ALL) patients face a dismal prognosis with a 5-year overall survival rate below 20% [ 6 ]. Consequently, there is a need to develop novel, more efficient, and safer strategies to enhance the prognosis of R/R- ALL.…”

Asia‐Pacific Leukemia Consortium: An innovative and collaborative initiative to improve care of leukemia and related diseases in the Asia‐Pacific region

“…More clinical trials are needed to standardize therapy and improve patient outcomes from an Asian perspective. Other barriers to the implementation of effective leukemia management in low‐ or mid‐income Asian countries include (i) education and training of patients, community, and healthcare professionals (HCPs); (ii) development of local nongovernmental organizations that provide psychosocial and financial support; (iii) alliances that combine government, public and private sectors, and medical societies; (iv) international collaborations and clinical trials; (v) health insurance; and (vi) data collection and research 17,21,22 . The Asia‐Pacific Leukemia Consortium (APLC) was established on the 8 September 2021 with the aim to understand the current status quo, unmet needs, and different ways to improve the medical management of leukemia and related diseases in the APAC region.…”

Childhood cancer survivorship in China: An overview of the past two decades

“…The event‐free survival and overall survival of childhood cancer, especially acute lymphoblastic leukemia, have increased in China 5,6 . The growing population of childhood cancer survivors resulted from improved survival highlights, the importance of cancer survivorship research in China.…”

“…4 The event-free survival and overall survival of childhood cancer, especially acute lymphoblastic leukemia, have increased in China. 5,6 The growing population of childhood cancer survivors resulted from improved survival highlights, the importance of cancer survivorship research in China. Importantly, compared to the U.S. and developed countries in Europe, the survival of childhood cancer patients in China remains inferior.…”