A gentler treatment for children whose leukaemia has returned could enhance survival rates and quality of life, according to a study from Great Ormond Street Hospital (Gosh). The new approach significantly reduces the need for intensive chemotherapy and has eliminated deaths linked to treatment in children with relapsed acute lymphoblastic leukaemia (ALL).
Study details and results
The UKALL Rel2020 study, published in the journal Leukemia, involved 188 children and young people aged one to 24 from 25 UK paediatric cancer centres between 2020 and 2024. Participants received less intensive chemotherapy followed by blinatumomab, a targeted immunotherapy that directs the immune system to attack leukaemia cells.
The new regimen achieved a remission rate of 92%, with long-term survival of 82% after three years, comparable to children on more intensive traditional plans. Notably, no patients died during the early phase of treatment, which experts describe as a major advancement in care.
Impact on patients
ALL is the most common childhood cancer in the UK, with around 400 new cases annually. While cure rates for newly diagnosed cases are high, relapse remains a challenge. Dr David O’Connor, consultant in paediatric haematology at Gosh, said: “This approach marks a major step forward in developing kinder treatments for children with relapsed cancer. By using lower-intensity chemotherapy and moving rapidly to blinatumomab, we were able to eliminate treatment-related deaths without compromising effectiveness.”
Romyn Winters, from Dunbar in East Lothian, Scotland, was diagnosed with ALL in October 2018 at age two. After relapse following standard chemotherapy, she received blinatumomab with lower-dose chemotherapy. Her parents, Lisa and John, noted: “Within days, she was back playing on the trampoline with her brothers. Romyn is now off treatment and recovering well.”
Real-world application
According to Gosh, the clinical trial is distinctive because it was delivered as routine NHS care, making results more representative of real-world patients. This study offers hope for safer, effective treatment options for children with relapsed leukaemia.
