Indian children suffering from a common form of leukaemia respond poorly to chemotherapy as compared to their western counterparts, found a study at the All India Institute of Medical Sciences (AIIMS).
The children studied were suffering from Acute Lymphoblastic Leukaemia (ALL), a cancer of the white blood cells.
It is the most common leukaemia found in children.
Dr Renu Saxena and Dr Sudha Sazawal were part of a five-member team from the Department of Haematology, AIIMS, which began the study in 2002.
They studied various factors that lead to poor prognosis among children with ALL.
The International Network for Cancer Treatment and Research (INCTR), an organisation based in Belgium, funded the research.
After studying about 70 children with ALL in the group 0 - 15 years for over 2 years, the team observed that 12:21, a good prognostic marker which tells how well a person is going to respond to therapy, is expressed only in 5 per cent of Indian children.
The same marker is expressed in about 30 per cent children in western countries.
The study was published in the Leukemia Research Journal that came out in the US in 2004.
Four years after the research has been published, the team, which had continued the study, stands by the inference.
“This research is an ongoing process with some variations here and there. But the results have been found more or less the same,” said Dr Saxena, Head of Haematology Department, AIIMS.
Another reason for not responding well to the therapy is found to be the presence of FLT-3 gene mutation, which was seen in about 17 per cent of the patients.
A patient doesn’t respond to the medication as desired, of the FLT-3 genegets mutated while the therapy is on.
“In order to improve outcome, it’s important to identify this mutation and, if present, give them FLT-3 inhibitors as part of their therapy,” said Dr Sazawal, a senior member of the AIIMS research team.
About 15 per cent of the patients on Imtinib, a drug given to these patients, develop resistance to it because of the T315 mutation, according to the research.
These patients are either put on other drugs like Dasatinib or Nilotinib, or need to be treated with aggressive chemotherapy.
Also, a patient’s economic condition and family willingness to start the therapy do play an important role in the outcome of the treatment.
“This treatment, apart from being expensive, entails a lot of side-effects and a lot of care. But still, about 90 per cent of the patients show willingness to continue with it,” said Dr Saxena.
The whole treatment, which is spread across 18 weeks, costs about Rs 6 lakh.