title: Risk factors for relapse in childhood acute lymphoblastic leukemia: prediction and prevention.
abstract: With current treatment regimens, survival rates for acute lymphoblastic leukemia (ALL) have improved dramatically since the 1980s, with current 5-year overall survival rates estimated at greater than 85%. This success was achieved, in part, through the implementation of risk-stratified therapy. Nevertheless, for a subgroup of patients (15-20%) with newly diagnosed ALL who will ultimately relapse, traditional risk assessment remains inadequate. The risk of relapse may be estimated on the basis of diagnostic features or early treatment response findings. Further progress in this field may thus come from refinement of predictive factors for relapse and treatment adaptation and from the identification of biological subsets of ALL patients who could benefit from specific target therapies. This article summarizes the aspects associated with the identification of predictive factors for relapse in childhood ALL and options available for prevention of disease recurrence.
authors.affiliation: Division of Haematology/Oncology, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ceppi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cazzaniga
authors.forename: Antonella
authors.initials: A
authors.lastname: Colombini
authors.forename: Andrea
authors.initials: A
authors.lastname: Biondi
authors.forename: Valentino
authors.initials: V
authors.lastname: Conter
mesh_terms: D002648:Child; D002675:Child, Preschool; D020869:Gene Expression Profiling; D006801:Humans; D007223:Infant; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000235:genetics / Q000517:prevention & control*; D011379:Prognosis; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*
keywords: acute lymphoblastic leukemia; early treatment response; gene expression profiling; minimal residual disease; pediatric; prognostic factor; risk factors for relapse