This proposal is for continuation of research into the natural history, treatment and epidemiology and of the statistical conduct, design, collation and publication of childhood cancer. It continues to emphasize the multimodal treatment aspects of the CCSG. Long term survival in all childhood malignancies regardless of diagnosis or age has now reached 50%. By research into the biology of these diseases and careful stratification by patient and tumor cell markers, treatment of all diseases has been broken down into many aspects. In this manner, certain groups of patients with acute lymphocytic leukemia have reached an 80% long term survival rate with minimal therapy. In non-Hodgkins lymphoma, Wilms tumor and rhabdomyosarcoma select groups have reached a 90- 95% disease free survival. Research into brain tumors has been ongoing for the past 5-8 years and multimodal therapy is now showing results of over 50%, which is also being seen in osteogenic sarcoma. The present proposal will accomplish further definition of these diseases and will look for ever better treatment results with less toxicity. In cooperation with the pediatric oncology group, important protocols have been designed or are about to be undertaken in hepatomas, Ewings sarcoma and certain types of brain tumors. In the period December 1982 through November 1987, this institution has seen a total of 689 patients with malignant disease, 424 of these were entered on CCSG studies. Professional personnel at CHMC are very active in CCSG activities. Dr. Chard, Principal Investigator, has been Associate Chairman for Leukemia studies and Vice Chairman of CCSG in he past and is presently Vice Chairman of studies for Acute Non-lymphocytic Leukemia. Dr. Bleyer is Associate Chairman for leukemia, Non-Hodgkins Lymphoma and New Agents. Dr. Bernstein is Chairman of the Immunology Committee, Dr. Pendergrass is a member of the Epidemiology Strategy Group. Dr. milstein, neurologist and Dr. Berger, neurosurgeon, are also members of brain tumor studies. Dr. Schaller, general surgeon, is a member of a number of surgical committees. CHMC in cooperation with the Fred Hutchinson Cancer Research Center is a major contributor to CCSG bone marrow transplantation studies.
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