Treatment of Pediatric B- and T-Cell Acute Lymphoblastic Leukemia

Acute lymphoblastic leukemia (ALL) is the most common childhood cancer, and treatments for both B- and T-ALL subtypes have been refined in ways that result in cures for the majority of children diagnosed every year in the United States and other developed countries. This has been achieved through dedicated clinical trials and research efforts to better understand disease biology and treatment response. However, there are challenges that remain. The prolonged treatment regimens for ALL are associated with toxicities both in the short and long term, with survivors at risk for multiple medical conditions. Survival rates for those children with relapsed or refractory (R/R) disease are poor, but the development of immunotherapies and other targeted agents for R/R disease is already having a positive impact. These approaches are currently being investigated in the frontline setting, bringing promise for continued outcome improvements, ideally with fewer adverse short- and long-term treatment effects.