Childhood acute lymphoblastic leukaemia and relapse

Summary Acute lymphoblastic leukaemia (ALL) is the most common childhood cancer. Treatment has improved but relapsed ALL remains more common than new cases of many ‘common’ paediatric malignancies. We have salvage regimens with substantial complete remission (CR) rates and increasing access to haema...

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Bibliographic Details
Published in:British journal of haematology 2005-12, Vol.131 (5), p.579-587
Main Author: Gaynon, Paul S.
Format: Article
Language:English
Subjects:
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Child
childhood leukaemia
haemopoietic stem cell transplantation
Hematologic and hematopoietic diseases
Hematology
Hematopoietic Stem Cell Transplantation
Humans
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Medical sciences
Neoplasm, Residual - therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy
Salvage Therapy - methods
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Summary:Summary Acute lymphoblastic leukaemia (ALL) is the most common childhood cancer. Treatment has improved but relapsed ALL remains more common than new cases of many ‘common’ paediatric malignancies. We have salvage regimens with substantial complete remission (CR) rates and increasing access to haematopoietic stem cell transplantation, but most patients who relapse die. We need better therapies. Insights into pharmacology may guide more effective use of existing agents. Novel agents with activity against resistant lymphoblasts offer an appealing strategy. However, most candidate agents fail, despite enthusiastic investigators, intriguing mechanisms of action and ‘compelling’ preclinical data. A number of existing combinations provide a 40% complete response rate in second or third relapse. Yet survival in third remission is
ISSN:0007-1048
1365-2141
DOI:10.1111/j.1365-2141.2005.05773.x