Paediatric Cancer Clinical Outcomes




Acute Lymphoblastic Leukaemia (ALL) Clinical Outcomes

Our research protocols have improved the results of treatment of children with ALL in Singapore since 1988. Our cure rates have improved from 62% in 1988-1996 to 84% in 2002-2010. Currently our multi-centre Malaysia-Singapore trials have allowed highly accurate prediction of outcome and tailoring therapy to maximise the chance of cure and minimising toxicity. This is now expanded into a multi-centre study sponsored by National Medical Research Council, Children’s Cancer Foundation and Viva Foundation for Children with Cancer.


Acute Myeloid Leukaemia (AML) Clinical Outcomes


The NCIS started implementing the MRC AML 10 (Medical Research Council Acute Myeloid Leukemia 10) Trial protocol in their treatment of AML patients since Sept 1996. With this new protocol, treatment duration is shortened (5 months instead of the conventional 2 years) in the treatment of AML. Via this form of treatment, the team has achieved a significantly better 3-year overall (74% vs 35%), event-free (77% vs 20%) and disease-free (83% vs 31%) survival. They were also more likely to achieve a complete remission than non-MRC AML 10 patients. About 60% of these children are expected to be cured.


Currently children diagnosed with AML at the NCIS will be enrolled in the St Jude AML 08 study. This study is funded by a grant from the Viva Foundation for Children with Cancer and Goh Foundation. Children with AML will be randomly assigned to either standard chemotherapy (cytarabine-daunorubicin-etoposide) or experimental chemotherapy (clofarabine-cytarabine). Clofarabine is a promising new drug which does not have long term risk of heart damage unlike daunorubicin.


Children with standard risk AML do not do as well on chemotherapy alone. They will receive natural killer cells from one of their parents as the final part of their therapy. Natural killer cells are part of our body’s natural immunity that guards against cancer and viral infections. It is hoped that natural killer cell therapy will improve the outcome for children with standard risk AML.

St Jude-Viva Foundation Programme

In 2008, the Viva Foundation for Children with Cancer (Singapore) identified the NCIS as the Centre for Excellence to develop their St Jude-Viva Programme in Singapore. Viva Foundation is a charity foundation which aims to improve the cure of childhood cancer in Singapore and the Asian region. St Jude Children’s Research Hospital is the top cancer hospital for children in the world.

The NCIS together with NUS, Viva Foundation and St Jude will work towards improving the cure for children with cancer in Singapore and beyond. The St Jude AML 08 study is the first of such unique collaboration to improve treatment of cancer in Singapore.

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