• The lancet oncology · May 2013

    Review

    Relapsed childhood acute lymphoblastic leukaemia.

    • Deepa Bhojwani and Ching-Hon Pui.
    • Department of Oncology, St Jude Children's Research Hospital, Memphis, TN 38015, USA. deepa.bhojwani@stjude.org
    • Lancet Oncol.. 2013 May 1;14(6):e205-17.

    AbstractWith steadily improved cure rates for children with newly diagnosed acute lymphoblastic leukaemia (ALL), treating relapsed ALL has become increasingly challenging largely due to resistance to salvage therapy. Improved biological understanding of mechanisms of relapse and drug resistance, the identification of actionable molecular targets by studying leukaemic cell and host genetics, precise risk stratification with minimum residual disease measurement, and the development of new therapeutic drugs and approaches are needed to improve outcomes of relapsed patients. Molecularly targeted therapies and innovative immunotherapeutic approaches that include specialised monoclonal antibodies and cellular therapies hold promise of enhanced leukaemia cell killing with non-overlapping toxicities. Advances in preparative regimens, donor selection, and supportive care should improve the success of haemopoietic stem-cell transplantation for high-risk patients.Copyright © 2013 Elsevier Ltd. All rights reserved.

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