Children with acute lymphoblastic leukemia a better chance

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Children with acute lymphoblastic leukemia a better chance

Published: 23 Apr. 2025, 12:56 Updated: 23 Apr. 2025, 19:23

Audio report: written by reporters, read by AI

Pediatric cancer patients participate in a coding class at Chonnam National University Hwasun Hospital in Hwasun, North Jeolla, on April 18. [JANG JEONG-PIL]

Determined to give every child an equal shot at survival, Korean doctors have launched the nation’s first standardized treatment protocol for pediatric acute lymphoblastic leukemia (ALL), unifying care across hospitals and ending decades of fragmented practices.

ALL is the most common pediatric cancer in Korea, and each year, around 250 children in the country are newly diagnosed with the disease.

Until recently, treatment protocols were often borrowed from countries like the United States. Chemotherapy drugs, dosage schedules and diagnostic standards varied across hospitals. As a result, treatment outcomes differed even for patients with the same diagnosis. The lack of consistency also made it challenging to analyze and compare results.

Though medical associations had attempted to unify treatment protocols, participation was limited to a small number of hospitals. Then, a breakthrough arrived unexpectedly, with a donation from the family of late Samsung Chairman Lee Kun-hee.

In 2021, Lee’s family donated 300 billion won ($209 million) to Seoul National University Hospital, earmarked for combating pediatric cancer and rare diseases.

A relief of late Samsung Group Chairman Lee Kun-hee is seen installed in the lobby on the first floor of Seoul National University Children's Hospital in Jongno District, central Seoul, on June 26, 2024. [JANG JIN-YOUNG]

With that funding, top pediatric oncology specialists from around the country came together to analyze the latest clinical data and engage in collaborative discussions.

Their efforts culminated in September 2023 with the establishment of Korea’s standardized treatment protocol for ALL. Patients are now categorized into standard-risk, high-risk, very high-risk, infant and relapsed groups, with optimized treatment plans developed for each. These protocols received government approval and are now in clinical use.

At the heart of this initiative is a nationwide hospital network connecting Seoul and regional provinces. Leading pediatric cancer doctors from both Seoul and regional hospitals are participating. A system has been created in which hospitals nationwide send patient samples, such as bone marrow, for advanced testing like whole genome sequencing (WGS), and receive detailed diagnostic reports prepared by specialists.

“Genetic testing of leukemia cells from bone marrow greatly aids in determining the intensity and direction of treatment,” said Professor Baek Hee-jo of Chonnam National University Hwasun Hospital. “It enables far more precise therapy.”

Hospital staff and Kim Bong-hak, director of the Gwangju-North Jeolla branch of Childhood Cancer Korea, hand out Christmas gifts at a pediatric wing of Chonnam National University Hwasun Hospital in Hwasun, North Jeolla, on Dec. 24, 2024. [YONHAP]

These genomic insights help physicians fine-tune treatment intensity and determine whether stem cell transplantation is needed, something impossible with traditional testing. A multidisciplinary team of specialists from departments like pediatrics and laboratory medicine also meets virtually to review complex cases.

“The ability to consult with experts when questions arise from the results is invaluable,” said Baek.

“In some cases, a patient may initially be classified as standard-risk based on conventional tests, but then found to be high- or very high-risk based on genetic analysis,” said Baek. “If a patient is found to have reduced metabolic capacity for certain drugs due to their genetic profile, alternative treatments can be considered.”

Another key advancement is minimal residual disease (MRD) testing, which can detect even one remaining cancer cell in 10,000. This is crucial for determining the duration of chemotherapy.

Samsung Electronics Executive Chairman Lee Jae-yong, second from left, and Honorary Director of Leeum Museum Hong Ra-hee attend an event for pediatric cancer at Seoul National University Children's Hospital in Jongno District, central Seoul, on Oct. 21, 2024. [YONHAP]

“This test is more than 100 times more precise than conventional microscopic examination of bone marrow,” Baek said. “Thanks to the donation, patients can now receive personalized treatment without bearing the cost.”

Baek also participates in a government-led initiative launched last year to build a national pediatric cancer care system.

“Because pediatric cancer affects fewer patients, it's often overlooked in terms of funding and support,” Baek said. “But this is an investment in our country's future and deserves special consideration.”

“Among patients classified as standard-risk, the cure rate in Korea is close to 90 percent — but we still lag behind the United States by 3 to 5 percentage points,” said Professor Ju Hee-young of Samsung Medical Center, who leads the standard-risk treatment group.

“In the United States, hospitals have been participating in nationwide standardized treatment studies since the 1960s, which significantly improved pediatric cancer survival rates,” said Ju. “If we continue treating Korean patients with a uniform approach for the next 10 years and refine it based on collected data, we can bring our cure rates to the highest level in the world.”

Pediatric cancer patients participate in a coding class at Chonnam National University Hwasun Hospital in Hwasun, North Jeolla, on April 18. [JANG JEONG-PIL]

Translated from the JoongAng Ilbo using generative AI and edited by Korea JoongAng Daily staff.
BY RHEE ESTHER [[email protected]]