Lynda M Vrooman1, Lewis B Silverman. 1. Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA. lynda_vrooman@dfci.harvard.edu
Abstract
PURPOSE OF REVIEW: With current treatment regimens, event-free survival rates for childhood acute lymphoblastic leukemia (ALL) approach or exceed 80%. This success was achieved, in part, through the implementation of risk-stratified therapy. However, for the 15-20% of children with newly diagnosed ALL who will ultimately relapse, traditional risk assessment remains inadequate. This review highlights recent advances in our understanding of prognostic factors that may be used to refine risk group classification. RECENT FINDINGS: An increasingly sophisticated understanding of genetic abnormalities in leukemia cells (including chromosomal abnormalities and patterns of gene expression), response to treatment, and host pharmacogenomics offers the potential to enhance or supplant currently applied prognostic criteria for use in treatment planning for childhood ALL. SUMMARY: Identification of biologically distinctive subsets of ALL through cytogenetic, molecular, and gene expression studies, as well as investigations of minimal residual disease and host pharmacogenomics, offer promising avenues of research. Integration of molecular tools into clinical practice will ultimately allow for more precise risk stratification and individualized treatment planning.
PURPOSE OF REVIEW: With current treatment regimens, event-free survival rates for childhood acute lymphoblastic leukemia (ALL) approach or exceed 80%. This success was achieved, in part, through the implementation of risk-stratified therapy. However, for the 15-20% of children with newly diagnosed ALL who will ultimately relapse, traditional risk assessment remains inadequate. This review highlights recent advances in our understanding of prognostic factors that may be used to refine risk group classification. RECENT FINDINGS: An increasingly sophisticated understanding of genetic abnormalities in leukemia cells (including chromosomal abnormalities and patterns of gene expression), response to treatment, and host pharmacogenomics offers the potential to enhance or supplant currently applied prognostic criteria for use in treatment planning for childhood ALL. SUMMARY: Identification of biologically distinctive subsets of ALL through cytogenetic, molecular, and gene expression studies, as well as investigations of minimal residual disease and host pharmacogenomics, offer promising avenues of research. Integration of molecular tools into clinical practice will ultimately allow for more precise risk stratification and individualized treatment planning.
Authors: Alejandro Gutierrez; Suzanne E Dahlberg; Donna S Neuberg; Jianhua Zhang; Ruta Grebliunaite; Takaomi Sanda; Alexei Protopopov; Valeria Tosello; Jeffery Kutok; Richard S Larson; Michael J Borowitz; Mignon L Loh; Adolfo A Ferrando; Stuart S Winter; Charles G Mullighan; Lewis B Silverman; Lynda Chin; Stephen P Hunger; Stephen E Sallan; A Thomas Look Journal: J Clin Oncol Date: 2010-07-19 Impact factor: 44.544
Authors: Stuart S Winter; Jerec Ricci; Li Luo; Debbie M Lovato; Hadya M Khawaja; Tasha Serna-Gallegos; Natalie Debassige; Richard S Larson Journal: Health (Irvine Calif) Date: 2013-05
Authors: Raquel Malumbres; Vicente Fresquet; Jose Roman-Gomez; Miriam Bobadilla; Eloy F Robles; Giovanna G Altobelli; M José Calasanz; Erlend B Smeland; Maria Angela Aznar; Xabier Agirre; Vanesa Martin-Palanco; Felipe Prosper; Izidore S Lossos; Jose A Martinez-Climent Journal: Haematologica Date: 2011-04-01 Impact factor: 9.941
Authors: Victoria L Bentley; Chansey J Veinotte; Dale P Corkery; Jordan B Pinder; Marissa A LeBlanc; Karen Bedard; Andrew P Weng; Jason N Berman; Graham Dellaire Journal: Haematologica Date: 2014-10-03 Impact factor: 9.941