Rahul Kumar, Medical Oncology Trainee at AIIMS, New Delhi, shared a post on X:
“Excited to share my MD thesis work, now published in Supportive Care in Cancer (2025) – the first-ever pediatric trial on scalp cooling to prevent chemo-induced alopecia in children with ALL. Grateful to my guide Aditya Kumar Gupta.
Why this matters
Hair loss is among the most distressing toxicities of chemotherapy in children – affecting self-esteem, peer interaction, & adherence. Until now, no pediatric data existed for scalp cooling.
Study design
- Investigator-initiated, prospective, non-randomized trial
- 22 children (median age 6 yrs) with ALL (IR/HR)
- Daunorubicin + Vincristine (ICiCLe protocol)
- Pre-cooled Elasto-Gel® caps applied
- → 30 min before, during 60 min infusion, +30 min post.
Primary endpoint: Successful hair preservation (CTCAE v5.0 Grade 1, < 50% loss) at end of induction (~Day 35)
Results
- Scalp cooling group: 9/10 (90%) preserved hair
- Non-cooling: 2/9 (22%) p = 0.005
- Dermal thickness reduction: –0.03 mm vs –0.3 mm (p = 0.049)
- SEM: shaft diameter & cuticular scales far better preserved (p = 0.005, p = 0.0004)
Microscopic & imaging insights
- Ultrasound: thicker dermis with cooling
- SEM (pg 6): smoother cuticle, denser scales
- Trichoscopy (pg 7): minimal follicular miniaturization
- Trichogram: fewer dystrophic anagen follicles (54% vs 75%)
Tolerability
No headache, chills, or cold intolerance,
Mild transient discomfort in 3/10—none discontinued.
Take-home
Pediatric scalp cooling is:
– Feasible
– Safe
– Effective
Demonstrates protection from macro- to ultrastructural level (clinical → USG → SEM → trichoscopy).
Next steps
- Larger multicentric randomized trial to confirm these findings
- Long-term follow-up for safety in hematologic malignancies
Scalp cooling may soon redefine supportive care in pediatric oncology.”
Title: Efficacy of scalp cooling to prevent chemotherapy-induced alopecia in children with acute lymphoblastic leukemia: A non-randomized trial
Authors: Rahul Kumar, Satya Prakash, Shivam Bansal, Rhea Ahuja, Nikhil Mehta, Neetu Bhari, Manisha Jana, Subhash Yadav, Jagdish Prasad Meena, Rachna Seth, Aditya Kumar Gupta
More posts about Supportive Care on OncoDaily.