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Advances in childhood leukaemia: successful clinical‐trials research leads to individualised therapy
Author(s) -
Ziegler David S,
Marshall Glenn M,
Dalla Pozza Luciano,
Waters Keith D
Publication year - 2005
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2005.tb06581.x
Subject(s) - medicine , neurocognitive , disease , minimal residual disease , oncology , intensive care medicine , pediatrics , chemotherapy , clinical trial , leukemia , psychiatry , cognition
In most cases, childhood leukaemia has a fetal origin, but multiple molecular events are required after birth for pre‐leukaemic cells to progress to leukaemia. Cure rates for acute lymphoblastic leukaemia (ALL) now approach 80%. A high level of minimal residual disease detected by polymerase chain reaction in patients with ALL in remission has profound prognostic importance and is the focus of a major Australian study attempting to prevent relapse in these children. Greater awareness of the late effects of chemotherapy has led to changes in the treatment protocols for ALL, with improvement in neurocognitive outcomes and reduced rates of second malignancies. Pharmacogenetics is a new field of research that aims to enhance treatment efficacy by assessing the individual's metabolism of and response to chemotherapeutic agents. Targeted therapies currently being developed show some promise of being able to further improve cure rates. Adolescents with ALL have a better prognosis if treated with paediatric rather than adult protocols.