A gentler treatment for children whose leukaemia has come back could boost survival and quality of life, according to a study led by doctors at Great Ormond Street Hospital (Gosh). The new regime reduces the need for intensive chemotherapy and eliminates deaths linked to treatment in children with relapsed acute lymphoblastic leukaemia (ALL).
Study findings
The UKALL Rel2020 study involved 188 children and young people aged one to 24, recruited from 25 UK paediatric cancer centres between 2020 and 2024. Participants received less intensive chemotherapy before transitioning to blinatumomab, a targeted immunotherapy that directs the immune system to attack leukaemia cells. The approach achieved remission rates of 92 per cent, with long-term survival (82 per cent after three years) comparable to traditional intensive treatment plans. Notably, no patients died during the early phase of treatment, which experts describe as a major leap forward in care.
Dr David O’Connor, consultant in paediatric haematology at Gosh, stated: “This approach marks a major step forward in developing kinder treatments for children with relapsed cancer. The early phase of treatment has traditionally carried significant risks. By using lower-intensity chemotherapy and moving rapidly to blinatumomab, we were able to eliminate treatment-related deaths without compromising effectiveness.”
Patient story
Romyn Winters was two years old when her parents, Lisa and John from Dunbar, East Lothian, noticed she was unable to walk properly. In October 2018, tests confirmed ALL, and she received chemotherapy with harsh side effects. Within 18 months, she relapsed. Her family opted for blinatumomab with lower-dose chemotherapy, allowing Romyn to recover quickly and resume childhood activities. “Within days, she was back playing on the trampoline with her brothers,” her parents said. “Romyn is now off treatment and recovering well.”
Real-world impact
According to Gosh, the clinical trial is distinct because it was delivered as routine NHS care, making results more representative of real-world patients. ALL is the most common childhood cancer in the UK, with around 400 new cases annually. Although cure rates for newly diagnosed disease are high, relapse remains a challenge. This new approach offers hope for kinder, effective treatment.
