Consider Chemotherapy after Induction Failure for Childhood Leukemia

The study by Dr. Schrappe and colleagues, a "remarkable collaborative effort," demonstrates that "induction failure is not a single entity with a uniform prognosis but rather exhibits biologic and prognostic heterogeneity," said Dr. Karen R. Rabin.

Moreover, the "striking" finding that chemotherapy is superior to stem-cell transplantation in certain subgroups of patients "may substantially affect current practice, since stem-cell transplantation has generally been accepted as the preferred treatment for all cases of induction failure," she said.

Dr. Rabin is with the division of pediatric hematology/oncology at Texas Children’s Cancer Center and Baylor College of Medicine, Houston. She reported no financial conflicts of interest. These remarks were taken from her editorial comment accompanying Dr. Schrappe’s report (N. Engl. J. Med. 2012;366:1445-6).