South Asia

New Delhi, India

During the same trip, Magrath and Adde visited New Delhi to discuss the establishment of an INCTR Office in India at the Sir Ganga Ram Hospital in Delhi. They also discussed the results of an analysis of data from more than 1,000 patients with acute lymphoblastic leukemia (ALL) treated at three centers with protocol MCP841 between 1990 – 1997. A successor protocol to MCP841 is being developed with these same three centers. Molecular studies in ALL in India in collaboration with the King Fahad Children's Medical Center Research Department in Riyadh, Saudi Arabia, were also on the agenda.

Adde presented the analysis of the results obtained by the three participating centers in the project "Treatment of Acute Lymphoblastic Leukemia in Children and Young Adults with Protocol MCP841." Dr David Venzon and Dr David Lieuwheuer of the Biostatistics Branch of the NCI performed the statistical analysis, which revealed clear differences in the patient populations at the three centers at presentation, particularly with respect to the distribution of white counts, age, presence of organomegaly and T cell disease. The analysis of patient characteristics in Mumbai also revealed that the patient population at the Tata Memorial Hospital has changed over time. The group agreed that the data should be published, and that an abstract would be prepared by the INCTR for approval by the group and submitted to a suitable meeting. A complete manuscript will subsequently be submitted for publication.

Discussion of a successor protocol to MCP841 focused on the treatment regimen. Given the excellent results now being obtained in Mumbai, it was felt that the most appropriate design would be to use a basic MCP841 protocol, but to include additional induction/consolidation elements. Two possible new treatment schemas will be prepared by the INCTR and circulated to the group for consideration.

Dr Kishor Bhatia led a discussion about a plan for a detailed molecular analysis of ALL in India, and comparison with results from Saudi Arabia and Egypt. Dr Sultan Al-Sedairy, Director of the Research Centre of the King Faisal Specialist Hospital in Riyadh was also present at this meeting. Dr Al-Sedairy agreed to support the study in various ways, including training Indian technicians and investigators in Riyadh.