Current opinion in oncology
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To review and summarize the available evidence on factors predicting prognosis of children with relapsed acute lymphoblastic leukemia (ALL) and on the currently used treatment strategies, as well as on the most promising and innovative molecular or cellular therapies. ⋯ A significant proportion of children with relapsed ALL are salvaged by risk-oriented therapies. Novel agents should be integrated into combination regimens with the aim of further improving outcome of patients.
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Glial tumors of the central nervous system (CNS) are the leading cause of cancer-related death and morbidity in children. Their diagnosis/prognosis relies mainly on clinical and histopathological factors. However, pathological grading is particularly challenging as there is substantial molecular heterogeneity in pediatric CNS tumors, which results in variable biological behavior in tumors with potentially identical histological diagnoses or limited reliable measures of classification for given subgroups. Novel molecular markers/pathways identified by integrated genomic/transcriptomic/epigenomic studies of cohorts of pediatric gliomas are revolutionizing this field and are summarized herein. ⋯ Reappraisal of glioma classification using these novel biomarkers will likely change practice toward molecular pathology and their integration into clinical trials will enable personalized therapies based on the molecular fingerprint of individual tumors.