title: Acute lymphoblastic leukaemia.
abstract: Acute lymphoblastic leukaemia occurs in both children and adults but its incidence peaks between 2 and 5 years of age. Causation is multifactorial and exogenous or endogenous exposures, genetic susceptibility, and chance have roles. Survival in paediatric acute lymphoblastic leukaemia has improved to roughly 90% in trials with risk stratification by biological features of leukaemic cells and response to treatment, treatment modification based on patients' pharmacodynamics and pharmacogenomics, and improved supportive care. However, innovative approaches are needed to further improve survival while reducing adverse effects. Prognosis remains poor in infants and adults. Genome-wide profiling of germline and leukaemic cell DNA has identified novel submicroscopic structural genetic changes and sequence mutations that contribute to leukaemogenesis, define new disease subtypes, affect responsiveness to treatment, and might provide novel prognostic markers and therapeutic targets for personalised medicine.
authors.affiliation: Department of Oncology, St Jude Children's Research Hospital and University of Tennessee Health Science Center, Memphis, TN 38105, USA. hiroto.inaba@stjude.org
authors.forename: Hiroto
authors.initials: H
authors.lastname: Inaba
authors.forename: Mel
authors.initials: M
authors.lastname: Greaves
authors.forename: Charles G
authors.initials: CG
authors.lastname: Mullighan
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D064987:Cell- and Tissue-Based Therapy / Q000379:methods; D002493:Central Nervous System Diseases / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D002869:Chromosome Aberrations; D005260:Female; D005544:Forecasting; D020869:Gene Expression Profiling / Q000379:methods; D005787:Gene Frequency; D015322:Gene Rearrangement, B-Lymphocyte; D020022:Genetic Predisposition to Disease / Q000235:genetics; D015894:Genome, Human; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology / Q000235:genetics / Q000628:therapy; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D018570:Risk Assessment; D017422:Sequence Analysis, DNA; D014157:Transcription Factors / Q000235:genetics; D014178:Translocation, Genetic / Q000235:genetics; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D014157:Transcription Factors