Pediatric Leukemia and Lymphoma Treatment Options

Pediatric leukemia treatment options

The majority of our leukemia patients are enrolled in clinical trials and receive a combination of immunotherapy, chemotherapy, and other drugs, depending on the type of leukemia and your child’s needs. Stem cell transplantation may also be an option.

We are one of a few children’s hospitals in the country that routinely perform minimal residual disease testing to detect extremely small numbers of leukemia cells in your child’s blood to help inform treatment decisions.

Our researchers are also working to develop ways to predict the outcome of your child’s cancer treatment at diagnosis, helping us switch to another treatment if needed without wasting valuable time.

If you or your child is between the ages of 15 and 29, our Adolescent and Young Adult Cancer Program provides holistic treatment support, helping to meet the needs of a group usually not well served by standard care environments for children or adults. The program brings together Stanford experts to deliver personalized care in a unique environment that caters to the specific needs of teens and young adults. Services include mental health support, fertility preservation, assistance with planning for future education and career goals, and much more.

Pediatric leukemia clinical trials

Immunotherapy clinical trials for pediatric leukemia patients. Our researchers and doctors are breaking new ground in the promising field of cancer immunotherapy. When custom versions of your child’s T-cells are engineered to include a chimeric antigen receptor (CAR), and then the cells are returned to the your child’s body, your child’s immune system can identify and kill cancer cells.

So far, this approach has been effective in targeting acute lymphoblastic leukemia (ALL). In clinical trials, we are already seeing 80% response rates in children with ALL who had prior relapses or no other treatment options.

We are the only hospital in Northern California to offer these immunotherapy clinical trials for patients with leukemia:

  • CD19/CD22: A trial using CAR T cells to target two different proteins on the surface of cancer cells to stop the cancer from adapting and evading the immune system. This trial is for patients with relapsed (cancer went away after treatment and came back) or refractory (cancer never went away) acute lymphoblastic leukemia. This trial is only available at Stanford.
  • CD22: An only-at-Stanford trial to study if CAR T cells targeting CD22, a protein on the surface of cancer cells, are effective at treating children and young adults with certain types of leukemia and lymphoma.

Other clinical trials for pediatric leukemia patients. We are proud to partner with St. Jude Children’s Research Hospital to offer some of their cutting-edge clinical trials to your child. We are the only children’s hospital in Northern California to offer these trials. Patients enrolling in these trials have their cancer genetically sequenced, so that we can develop a targeted treatment plan to attack their cancer’s weakness.

  • Total Therapy XVII: This trial for patients with acute lymphocytic leukemia (ALL) customizes treatment based on each patient’s DNA in the hopes of increasing the chances of success and decreasing the side effects of treatment. ALL survival rates are now above 93%, and this trial seeks to boost those rates even further while also improving the patient’s quality of life. For example, patients with certain genes are more susceptible to side effects from a powerful anti-leukemia drug that make it difficult for them to walk normally after treatment. If we know that a patient has that gene, we can lower the dose of the culprit drug and incorporate physical therapy during treatment to improve the odds of the patient living a cancer-free life that allows for healthy movement.
  • AML16: This trial, co-developed by Stanford investigators, is for patients with acute myelogenous leukemia (AML). It will study whether giving AML patients a drug called DTMi before chemotherapy may help make treatment more effective. DTMi changes the DNA of leukemia cells, possibly making them more sensitive to chemotherapy.

We are also the only hospital in the United States currently offering a trial testing a promising drug called palbociclib in combination with chemotherapy in patients with ALL that is resistant to treatment or has returned after treatment. Palbociclib works by blocking proteins on the leukemia cells and has been shown to kill leukemia cells in the lab.

Stem cell transplantation for pediatric leukemia. Some patients with leukemia may benefit from stem cell transplantation. Leukemia starts in blood cells. If your child is a good fit for a stem cell transplant, your child is given a donor’s stem cells—cells that make blood cells—with the goal of enabling your child to create new, healthy blood cells. Our team of stem cell transplant specialists is working to make this procedure safer, more effective, and accessible to a wider group of patients.

For example, Stanford’s Alice Bertaina, MD, PhD, is a pioneer in a new procedure called alpha/beta T-cell depleted haploidentical stem cell transplantation, which greatly increases the number of patients who can receive transplants. This approach makes it possible to receive a transplant from a donor who is only a partial match while reducing the risk of graft-versus-host disease (GvHD) by removing some of the donor’s immune cells before transplant.

A new clinical trial only available at Stanford is testing whether cell therapy can make these alpha/beta T-cell depleted haploidentical stem cell transplants even safer and more effective. In the clinical trial, patients receive one of these unique stem cell transplants and then are given a cell therapy called T-allo10. This cell therapy is made from the cells of the same person who donated stem cells for the transplant. The cell therapy contains cells that tell the transplant recipient’s immune system to leave the transplanted stem cells alone. We are testing whether this approach can reduce GvHD even further and help the recipient’s immune system rebuild itself after transplant.

Pediatric lymphoma treatment options

Since the 1970s, our doctors have led the development of lymphoma treatments that have become increasingly more effective and safer.

We work with your family to develop a lymphoma treatment plan that’s right for your child. Chemotherapy is the mainstay of treatment for Hodgkin’s and non-Hodgkin’s lymphoma. Some patients may require radiation therapy as well. Our multidisciplinary care team includes internationally renowned doctors, pathologists, and radiation oncologists, and every case is discussed by a group of experts.

Pediatric lymphoma clinical trials

The vast majority of our lymphoma patients are enrolled in clinical trials. We are proud to partner with leading pediatric cancer centers such as St. Jude Children’s Research Hospital and Dana-Farber/Boston Children’s Cancer and Blood Disorders Center to develop new treatments. Our hospital is the only one in Northern California to offer these groundbreaking clinical trials:

  • Total Therapy XVII: This trial is for patients with acute lymphoblastic lymphoma (LLy). Based on genetic sequencing of your child’s cancer, this trial customizes treatment with the aim of finding the most effective, least harmful option.
  • cHOD17: This study, for patients with Hodgkin’s lymphoma, separates patients into different groups based on their risk of relapse and gives them different anti-cancer drugs.

You can find a list of current clinical trials for pediatric Hodgkin’s lymphoma and non-Hodgkin’s lymphoma on the Stanford Cancer Institute website. We are also studying the use of immunotherapy—an innovative new treatment that use the body’s own cells to fight cancer—as a treatment for lymphoma.