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Childhood Acute Lymphoblastic Leukemia
1Department of Hematology/Oncology, St. Jude Children's Research Hospital, Department of Pediatrics and University of Tennessee, College of Medicine, Memphis, Tennessee, 38105, USA. jeffrey.rubnitz@stjude.org
Abstract:
The cure rate for childhood acute lymphoblastic leukemia (ALL) now exceeds 70%. This success has been achieved in part by improvements in the biologic characterization of newly diagnosed patients. Modern treatment protocols rely on this information to tailor therapy to a patient's risk of relapse. Patients with favorable genetic features, such as hyperdiploidy or the TEL-AML1 fusion, can be treated with conventional antimetabolite-based therapy to minimize long-term side effects. By contrast, extremely high-risk patients, such as infants with MLL gene rearrangements and cases with BCR-ABL fusion and poor early response, are candidates for allogeneic hematopoietic stem cell transplantation in first remission. Future areas of research include the identification of new genetic subgroups of ALL and the development of novel therapies.