Coordinated care for innovative treatment of pediatric leukemia

Jan. 07, 2022

Acute leukemia is the most common cancer that affects children, according to the American Cancer Society. The treatment of childhood leukemia has become a shining example of how coordinated research can transform a disease from one that was previously incurable to one of which the majority of patients experience lifelong cures.

With these successes have come new challenges of adapting therapies to the individual patient to minimize side effects while continuing to maximize cures. As a result, modern leukemia diagnosis and treatment is highly individualized based on a patient's age, clinical features at diagnosis, the pace of disease response to therapy and a complex array of genomic characteristics. Now more than ever success requires the combined efforts of many specialists to tailor treatment to the individual.

The most common type of pediatric leukemia is acute lymphocytic leukemia (ALL), which the American Cancer Society reports accounts for about 75% of all childhood leukemia diagnoses. Acute myeloid leukemia (AML) is the second most common type in pediatric patients. Chronic leukemias are rare in children. Regardless of a child's diagnosis, pediatric patients with leukemia are seen within Mayo Clinic Children's Center's comprehensive, collaborative structure with access to multidisciplinary teams. In many cases, specialists can coordinate services to allow for the most efficient patient experience.

"I think a lot of families appreciate that coordination of care and expeditious workup," says Mira A. Kohorst, M.D., a pediatric hematologist/oncologist at Mayo Clinic Children's Center in Rochester, Minnesota. "We work on getting patients in for comprehensive evaluation with many providers and tests in a short period of time."

Pediatric care integrated with adult care providers

At Mayo Clinic Children's Center, pediatric leukemia care is done in close collaboration with those who care for adult patients. Unlike in many standalone children's hospitals, the resources and support of the adult program are readily accessible for Mayo Clinic physicians.

"Close integration with our adult counterparts is a unique and beneficial structure for Mayo Clinic Children's Center," says Dr. Kohorst. "There's a really nice collaboration with the adult leukemia practice and all of their available studies and clinical trials. We are even able to connect our adolescent and young adult patients with more-appropriate resources out of the adult leukemia programs."

This collaboration ensures efficient use of resources and direct access to the research and tactics in which the adult programs excel. For example, Mayo Clinic's adult leukemia programs are an industry leader in immunotherapies such as CAR-T cell therapy. Mayo Clinic's program is accredited by the Foundation for the Accreditation of Cellular Therapy.

Hematopathology expertise supports accurate diagnoses and the latest targeted therapy

Mayo Clinic Children's Center's expertise in pediatric leukemia starts with an accurate and complete diagnosis. It is not uncommon for a clarified diagnosis to come out of Mayo Clinic's onsite hematopathology team. Using this team's expertise and the latest diagnostic technologies as well as the novel and evolving technologies that provide a comprehensive genomic profile of a patient's disease, pediatric hematologists/oncologists can then find the most suitable therapies to treat the patient's cancer.

This expertise leads to the availability of the latest targeted treatments and therapies for pediatric leukemia. At Mayo Clinic Children's Center, patients have access to emerging immunotherapies, CAR-T cell therapy and other immune effector cell therapies. Being able to use these specific immunotherapies can improve efficacy while decreasing toxicity to the patient. Mayo Clinic Children's Center also has a robust and growing pediatric hematopoietic cell transplant program.

"That's one of the areas that has been really exciting in the field," says Dr. Kohorst. "Using the immune system to fight cancer has been particularly effective in leukemia. We're always working toward bringing more of those types of trials and capabilities into our practice."

Mayo Clinic Children's Center is a one-stop destination medical center for children with acute leukemia. Thorough and accurate diagnosis is coupled with individualized therapies provided by highly trained and experienced care teams. The availability of a wide variety of transplant and immunotherapeutic options creates an environment where children at all stages of their journey can find expert, compassionate care.

For more information

Refer a patient to Mayo Clinic.