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Previous Volume 354:166-178 January 12, 2006 Number 2 Next

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Almost 4000 cases of acute lymphoblastic leukemia (ALL) are diagnosed annually in the United States, approximately two thirds of which are in children and adolescents, making ALL the most common cancer in these age groups.¹ Optimal use of the same antileukemic agents that were developed from the 1950s through the 1980s, together with a stringent application of prognostic factors for risk-directed therapy in clinical trials, has resulted in a steady improvement in treatment outcome.¹ In the 1990s, the five-year event-free survival rates for childhood ALL generally ranged from 70 to 83 percent in developed countries (Table 1),^{2,3,4,5,6,7,8,9,10,11} with . . . [Full Text of this Article]

Risk Assessment

Factors Predicting Clinical Outcome

Treatment Regimen

Clinical Features

Genetics of Leukemia Cells

Host Pharmacodynamics and Pharmacogenetics

Global Gene-Expression Patterns

Early Response to Treatment

Factors Predicting Treatment-Related Toxic Effects

Treatment

Remission Induction

Intensification (Consolidation) Therapy

Allogeneic Hematopoietic Stem-Cell Transplantation

Continuation Treatment

Treatment Directed to the Central Nervous System

Future Directions

Source Information

From the Departments of Hematology and Oncology (C.-H.P.), Pharmaceutical Sciences (W.E.E.), and Pathology (C.-H.P.), St. Jude Children's Research Hospital; and the Colleges of Medicine (C.-H.P., W.E.E.) and Pharmacy (W.E.E.), University of Tennessee Health Science Center — both in Memphis.

Address reprint requests to Dr. Pui at St. Jude Children's Research Hospital, 332 N. Lauderdale St., Memphis, TN 38105-2794, or at ching-hon.pui@stjude.org.

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