Childhood acute lymphoblastic leukaemia--current status and future perspectives

The Lancet Oncology
C H PuiWilliam E Evans

Abstract

The current cure rate of 80% in childhood acute lymphoblastic leukaemia attests to the effectiveness of risk-directed therapy developed through well-designed clinical trials. In the past decade there have been remarkable advances in the definition of the molecular abnormalities involved in leukaemogenesis and drug resistance. These advances have led to the development of promising new therapeutic strategies, including agents targeted to the molecular lesions that cause leukaemia. The importance of host pharmacogenetics has also been recognised. Thus, genetic polymorphisms of certain enzymes have been linked with host susceptibility to the development of de novo leukaemia or therapy-related second cancers. Furthermore, recognition of inherited differences in the metabolism of antileukaemic agents has provided rational selection criteria for optimal drug dosages and scheduling. Treatment response assessed by measurements of submicroscopic leukaemia (minimal residual disease) has emerged as a powerful and independent prognostic indicator for gauging the intensity of therapy. Ultimately, treatment based on biological features of leukaemic cells, host genetics, and the amount of residual disease should improve cure rates further.

Associated Clinical Trials

Sep 23, 2016·Kjeld Schmiegelow

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Citations

Jan 6, 2004·International Journal of Hematology·Yasuhide Hayashi
Feb 13, 2003·Pathology Oncology Research : POR·Agnes ZvaraLászló G Puskás
Jan 20, 2011·Archivum Immunologiae Et Therapiae Experimentalis·Joanna SzczepanekMariusz Wysocki
Jul 1, 2008·Current Hematologic Malignancy Reports·Dario Campana
Aug 14, 2012·World Journal of Pediatrics : WJP·Veerajalandhar AllareddyVeerasathpurush Allareddy
Mar 14, 2003·Cancer Treatment Reviews·Jeffrey E Rubnitz, Ching-Hon Pui
Feb 10, 2004·Cancer Treatment Reviews·Sabine L A PlasschaertEveline S J M de Bont
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Nov 1, 2003·Best Practice & Research. Clinical Haematology·María B VidrialesDario Campana
Nov 5, 2008·Nature Clinical Practice. Oncology·Philip SavageTim Crook
Apr 16, 2002·Current Problems in Pediatric and Adolescent Health Care·Ka Wah Chan
Aug 6, 2004·The New England Journal of Medicine·Amy HollemanWilliam E Evans
Apr 9, 2004·The New England Journal of Medicine·Ching-Hon PuiJames R Downing
Sep 19, 2003·The New England Journal of Medicine·Gregory L KearnsRalph E Kauffman
Jan 13, 2006·The New England Journal of Medicine·Ching-Hon Pui, William E Evans
Feb 7, 2003·Journal of Pediatric Hematology/oncology·Geoffrey A M NealeChing-Hon Pui
Jun 4, 2002·Current Opinion in Hematology·Mignon L Loh, Jeffrey E Rubnitz
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Sep 28, 2012·The Pediatric Infectious Disease Journal·Marta Zapata-TarrésMiguel Angel Palomo-Colli
Sep 1, 2007·Journal of Pediatric Hematology/oncology·Nadia DakkaAbdelaziz Benjouad
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Sep 9, 2008·Journal of Pediatric Hematology/oncology·Maria Teresa Amparo BuendiaGonzalo Guevara
Jan 13, 2006·Annual Review of Pharmacology and Toxicology·Meyling H CheokWilliam E Evans

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