Acute lymphoblastic leukemia relapse: biomarkers, hopes, and challenges

Acute lymphoblastic leukemia (ALL) is a rare disease in adults, but is the most common pediatric malignancy and the leading cause of death among children with cancer worldwide. While initial treatment regimens induce remission in most patients, relapses still occur in many cases during or after treatment. Relapses are difficult to treat and continue to be one of the leading causes of ALL-related deaths. Thus, it is essential to understand the biological mechanisms underlying ALL relapses, and to identify reliable biomarkers for better relapse risk prediction and novel druggable targets for precision treatments tailored to risk profiles. Here we review the latest developments in ALL research with a focus on relapse mechanisms, and we discuss related hopes and challenges.