The treatment program for both groups is separated into 4 phases. IKZF1 deletions in pediatric acute lymphoblastic leukemia: still a poor prognostic marker? Acute lymphoblastic leukaemia (also called ALL or ALL leukemia) is a rare cancer of the blood cells. Bortezomib is a proteasome inhibitor with activity in pediatric acute lymphoblastic leukemia. eCollection 2020. Bader P, Kreyenberg H, Hoelle W, Dueckers G, Handgretinger R, Lang P, Kremens B, Dilloo D, Sykora KW, Schrappe M, Niemeyer C, Von Stackelberg A, Gruhn B, Henze G, Greil J, Niethammer D, Dietz K, Beck JF, Klingebiel T. J Clin Oncol. When cancer returns, it is called relapse or recurrence. J Clin Oncol 1994;12:740–747. NIH In general, treatment for acute lymphocytic leukemia falls into separate phases: 1. Newly diagnosed childhood acute lymphoblastic leukemia: update on prognostic factors and treatment. 2003 Jul;10(4):290-6. doi: 10.1097/00062752-200307000-00007. This review considers recent advances in the treatment … Br J Haematol. COVID-19 is an emerging, rapidly evolving situation. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Chemotherapy refers to medicines that help fight cancer. On current treatment regimens, the intensity of upfront treatment is stratified based upon prognostic factors with the … The use of risk-adapted treatment protocols has improved cure rates while limiting the toxicity of therapy. Children and adolescents with relapsed acute lymphoblastic leukemia (ALL) are treated at Dana-Farber/Boston Children's Cancer and Blood Disorders Center through the Childhood Leukemia Program, one of the top pediatric leukemia treatment programs in the world. On current treatment regimens, the intensity of upfront treatment is stratified based upon prognostic factors with the aim of improving cure rates (for those at the highest risk of relapse) and minimizing treatment-related morbidity (for lower-risk patients). Symptoms may include feeling tired, pale skin color, fever, easy bleeding or bruising, enlarged lymph nodes, or bone pain. -. Survival of relapsed patients can be predicted by site of relapse, length of first complete remission, and immunophenotype of relapsed ALL. Acute lymphocytic leukemia is the most common childhood cancer, although it can develop in adults, too. Please enable it to take advantage of the complete set of features! 2013 Sep;162(5):606-20. doi: 10.1111/bjh.12442. Patients will be separated into "Standard Risk" and "High Risk". PubMed Google Scholar Childhood acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Asai D, Imamura T, Suenobu S, Saito A, Hasegawa D, Deguchi T, Hashii Y, Matsumoto K, Kawasaki H, Hori H, Iguchi A, Kosaka Y, Kato K, Horibe K, Yumura-Yagi K, Hara J, Oda M; Japan Association of Childhood Leukemia Study (JACLS). 2 Sidney Farber’s groundbreaking work with aminopterin was the first successful use of a drug to induce … HHS Standard treatment of recurrent childhood acute lymphoblastic leukemia (ALL) for leukemia that comes back in the bone marrow may include the following: Combination chemotherapy . The most common cause of treatment failure in childhood acute lymphoblastic leukemia (ALL) remains relapse, occurring in ~ 15%-20% of patients. Most treatment plans use daily 6-mercaptopurine (6-MP) and weekly methotrexate, given as pills, often along with vincristine, which is given into a vein (IV), and a steroid (prednisone or dexamethasone). Childhood acute lymphoblastic leukemia (ALL) treatment is usually chemotherapy given in phases and determined by risk group. Treatment costs were calculated based on patient … Standard treatment of recurrent childhood acute lymphoblastic leukemia (ALL) for leukemia that comes back in the bone marrow may include the following: Combination chemotherapy . It can also occur in older children and adolescents. Author information: (1)Clinical Investigations Branch, Cancer Treatment Evaluation Program, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA. Treatment of childhood ALL usually occurs in phases: First phase — induction therapy. Treatment for acute lymphoblastic leukemia usually begins by addressing the signs and symptoms your child has such as anemia, bleeding and/or infection. Radiation to the testicles: In most cases, acute lymphoblastic leukemia that is present in the testicles at diagnosis goes away quickly during the first month of treatment. Chemotherapy with or without total-body irradiation followed by a stem cell transplant , using stem cells from a donor . Br J Haematol. Supported by the Deutsche Krebshilfe, the Bundesministerium für Bildung und Forschung, the Madeleine Schickedanz Kinderkrebsstiftung, and the Deutsche José Carreras-Leukämie-Stiftung. Treating Acute Lymphocytic Leukemia (ALL) Chemotherapy for Acute Lymphocytic Leukemia (ALL) Targeted Therapy for Acute Lymphocytic Leukemia (ALL) Immunotherapy for Acute Lymphocytic Leukemia (ALL) Surgery for Acute Lymphocytic Leukemia (ALL) Radiation Therapy for Acute Lymphocytic Leukemia (ALL) Stem Cell Transplant for Acute Lymphocytic Leukemia (ALL) It can develop in people of any age, but is more common in children and young … In general, treatment for acute myeloid leukemia (AML) uses higher doses of chemo over a shorter period of time (usually less than a year), and treatment for acute lymphocytic leukemia (ALL) uses lower doses of chemo over a longer period of time (usually 2 to 3 years). Recurrent Childhood Acute Lymphoblastic Leukemia. In this disease, the body produces too many lymphoblasts (a type of white blood cell) and they become cancerous. 2020 Jan;19(1):549-556. doi: 10.3892/ol.2019.11064. IKZF1 deletion is associated with a poor outcome in pediatric B-cell precursor acute lymphoblastic leukemia in Japan. And adults may be able to continue working. ; Past treatment for cancer and certain genetic conditions affect the risk of having childhood ALL. The prognosis for children treated for ALL is very positive. It is separated into two groups based on the type of lymphocyte the leukemia started in. Current Treatment Approaches in Childhood Acute Lymphoblastic Leukemia Martin Schrappe, Martin Stanulla Abstract Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood and has served as a model system for clinical and basic research beyond pediatric hemato-oncology since the early 1960s. Radiation to the brain: Most of the chemotherapy drugs used to treat acute lymphoblastic leukemia don’t get into the brain and spinal fluid very well.Because of this, special approaches have to be used to kill ALL cells in these areas.  |  While the majority of children and adolescents with newly diagnosed childhood acute lymphoblastic leukemia (ALL) will be cured, as many as 20 % of patients will experience relapse. The five-year, event-free childhood acute lymphoblastic leukemia survival rate (which refers to survival without relapse) is about 85 percent. To help you cope, try to: Learn enough about leukemia to feel comfortable making treatment … 2012 Feb;156(3):358-65 Predicting relapse risk in childhood acute lymphoblastic leukaemia. Copyright © 2009 Elsevier Inc. All rights reserved. Leukemia and lymphoma are overlapping clinical presentations of the same disease. Montaño A, Hernández-Sánchez J, Forero-Castro M, Matorra-Miguel M, Lumbreras E, Miguel C, Santos S, Ramírez-Maldonado V, Fuster JL, de Las Heras N, García-de Coca A, Sierra M, Dávila J, de la Fuente I, Olivier C, Olazabal J, Martínez J, Vega-García N, González T, Hernández-Rivas JM, Benito R. J Pers Med. It affects slightly more … Consolidation therapy. The treatment program for both groups is separated into 4 phases. B-cell acute lymphoblastic leukemia (B-ALL) represents the malignant counterpart of bone marrow (BM) differentiating B cells and occurs most frequently in children. Increasing mixed chimerism is an important prognostic factor for unfavorable outcome in children with acute lymphoblastic leukemia after allogeneic stem-cell transplantation: possible role for pre-emptive immunotherapy? The goal of this phase is to kill any leukemia cells that remain after induction therapy. Children with acute lymphoblastic leukemia are treated somewhat differently depending on the relative risk of the leukemia recurring. While the goal of effective therapy for the majority of children with ALL has been achieved, significant numbers of patients still die due to recurrent disease or the toxicity of treatment. Chemotherapy with or without total-body irradiation followed by a stem cell transplant , using stem cells from a donor . About 8 out of 10 cases of ALL in children are B-cell ALLs. Treatment for acute lymphocytic leukemia can be a long road. Comprehensive Custom NGS Panel Validation for the Improvement of the Stratification of B-Acute Lymphoblastic Leukemia Patients. Chemotherapy is the main treatment for acute lymphoblastic leukaemia. But in 15-20 percent of cases in the United States — about 600 children — ALL comes back. The study of METTL3 and METTL14 expressions in childhood ETV6/RUNX1-positive acute lymphoblastic leukemia Mol Genet Genomic Med . Acute lymphoblastic leukemia (ALL) is a cancer of the blood and bone marrow. Standard treatment of relapsed childhood acute lymphoblastic leukemia (ALL) that comes back in the bone marrow may include the following: Combination chemotherapy. Treatment of Childhood Acute Lymphoblastic Leukemia. Prognostic significance of the tumor suppressor protein p53 gene in childhood acute lymphoblastic leukemia. Thus, future research must extend our molecular understanding of leukemia and host factors in order to even more specifically identify the mechanisms underlying the differences in treatment response and outcome, and to finally address the therapeutic needs of the individual child. While the majority of children and adolescents with newly diagnosed childhood acute lymphoblastic leukemia (ALL) will be cured, as many as 20 % of patients will experience relapse. While new combinations of chemotherapeutic agents have dramatically improved the prognosis for young patients, disease outcome remains poor after relapse or in adult patients. Our Program has played a leading role in refining treatment for childhood leukemia, resulting in today's cure … 2020 Sep 21;10(3):137. doi: 10.3390/jpm10030137. Studies in ALL have been a model for clinical and basic research beyond pediatric hemato-oncology. BM and early relapse (< 30 months from diagnosis), as well as T-ALL, are associated with … Get information about risk factors, signs, diagnosis, molecular features, survival, risk-based treatment assignment, and induction and postinduction therapy for children and adolescents with newly diagnosed and recurrent ALL. ALL most often occurs in children ages 2 to 5. Although the overall cure rate of acute lymphoblastic leukemia (ALL) in children is about 80 percent, affected adults fare less well. USA.gov. By continuing you agree to the use of cookies. There are different types of treatment for childhood acute lymphoblastic leukemia (ALL). 2014 Aug;166(3):421-4 Triggered by the observation of specific clinical presenting features, biological characteristics, and early treatment response being associated with treatment outcome, therapy intensity in contemporary ALL protocols is adjusted according to prognostic factors predicting the risk of relapse. Find out more about treating acute lymphoblastic leukaemia. Patients will be separated into "Standard Risk" and "High Risk".  |  This is likely due to … Epub 2013 Jun 29. There are about 3,000 cases of ALL in children and youth up to age 21 each year in the United States. It is separated into two groups based on the type of lymphocyte the leukemia started in. Epub 2020 Feb 25. 1 Before the 1950s, ALL was uniformly fatal, with an average survival of 3 months after diagnosis. Treatment of childhood acute lymphoblastic leukemia: results of Dana- Farber Cancer Institute/Children’ s Hospital Acute Lymphoblastic Leukemia Consortium Protocol 85–01. Cancer Med. 2013 Jun;2(3):412-9. doi: 10.1002/cam4.87. Acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood and has served as a model system for clinical and basic research beyond pediatric hemato-oncology since the early 1960s. -, Blood. ; Signs of childhood ALL include fever and … RATIONALE: L-asparaginase is an important component of treatment for childhood acute lymphoblastic leukemia, but is also associated with notable side-effects, including hypersensitivity, pancreatitis, and thrombosis. St. Jude researchers found unexpected genetic changes in a deadly type of childhood leukemia called ETP-ALL that could change diagnosis and treatment for children with this disease. However, the control of central nervous system (CNS) leukemia remains a therapeutic challenge in childhood ALL, partly because of the late complications arising from cranial irradiation. The most common type of leukemia in children is acute lymphoblastic leukemia (ALL). https://doi.org/10.1053/j.seminhematol.2008.09.007. About Childhood ALL Because of new and better therapies, cancer survival rates for children have improved dramatically during the last several decades. During maintenance phases, children can usually live a relatively normal life and go back to school. Epub 2013 May 9. Get information about risk factors, signs, diagnosis, molecular features, survival, risk-based treatment assignment, and induction and postinduction therapy for children and adolescents with newly diagnosed and recurrent ALL. Weng W, Zhang P, Ruan J, Zhang Y, Ba D, Tang Y. Oncol Lett. Childhood acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow makes too many immature lymphocytes (a type of white blood cell). These latter 2 drugs are given for brief periods every 4 to 8 weeks. For acute lymphoblastic leukemia (ALL), the 5-year survival rate has improved significantly since 1975. Relapsed childhood acute lymphoblastic leukemia. Chemotherapy with or without total-body irradiation followed by a stem cell transplant, using stem cells from a donor. The purpose of the first phase of treatment is to kill most of the leukemia cells in the blood and bone marrow and to restore normal blood cell production. BM and early rel … Learn more about the causes, risk factors, symptoms, diagnosis, treatment types, and prognosis for acute lymphoblastic leukemia. lncRNAs-mRNAs Co-Expression Network Underlying Childhood B-Cell Acute Lymphoblastic Leukaemia: A Pilot Study. The most common type of leukemia in children is acute lymphoblastic leukemia (ALL). Chemotherapy with or without total-body irradiation followed by a stem cell transplant, using stem cells from a donor. 2,3 By contrast, hypodiploidy (modal chromosome number fewer than 46) is associated with a poor outcome. Acute lymphoblastic leukemia (ALL) is a type of blood cancer. 2. RATIONALE: L-asparaginase is an important component of treatment for childhood acute lymphoblastic leukemia, but is also associated with notable side-effects, … -, Haematologica. It is the most common form of childhood cancer. 3. About 3,000 children and teens younger than 20 are diagnosed with ALL each year in the United States. As many as one third of all deaths in childhood acute lymphoblastic leukemia (ALL) are caused by toxicities or second malignant neoplasms (SMNs). 1–4 Previously reported cumulative incidences of SMNs have varied from less than 1% to 10% or more because of differences in antileukemic therapy and in duration, accuracy, and completeness of follow-up. Acute lymphoblastic leukemia (ALL) is a cancer of the lymphoid line of blood cells characterized by the development of large numbers of immature lymphocytes. Acute lymphoblastic leukemia (also called acute lymphocytic leukemia, or ALL) in children is cancer of the blood that starts in the bone marrow and spreads to the bloodstream. Childhood acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood. The treatment of relapsed or refractory acute lymphoblastic leukemia (ALL) in children is challenging and new treatment options are needed. Diagnosis and classification do not distinguish between these entities and they should be referred to collectively as ALL/LBL 2020 Sep 2;12(9):2489. doi: 10.3390/cancers12092489. ALL is the most common type of cancer and leukemia in children in the United States. The improvements in the treatment of ALL represent the work of cooperative groups at their best. Acute lymphoblastic leukemia (ALL) is the most common type of cancer in children. We also highlight novel treatment approaches aimed at improving outcomes in childhood ALL. Schorin MA, Blattner S, Gelber RD, et al. Acute lymphoblastic leukemia (ALL) is a cancer of the lymphoid line of blood cells characterized by the development of large numbers of immature lymphocytes. Different types of treatment are available for children with acute lymphoblastic leukemia (ALL). Complications of acute lymphoblastic leukaemia In order to compare costs of PEGasparaginase, Erwinia asparaginase and native E. coli asparaginase, we performed a cost-analysis in the Dutch Childhood Oncology Group ALL-10 medium-risk group intensification protocol. Children with acute lymphoblastic leukemia are treated somewhat differently depending on the relative risk of the leukemia recurring. doi: 10.1002/mgg3.933. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Second phase — consolidation therapy. Blood. Keywords: NLM The term leukemia comes from Greek words for white and blood, because ALL affects white blood cells. Affinito O, Pane K, Smaldone G, Orlandella FM, Mirabelli P, Beneduce G, Parasole R, Ripaldi M, Salvatore M, Franzese M. Cancers (Basel). 2020 Aug 25;10:1550. doi: 10.3389/fonc.2020.01550. Acute lymphoblastic leukemia; Relapse; Treatment. The improvement in survival for children and young adults with acute lymphoblastic leukemia (ALL) is a remarkable 70-year success story of science and medicine. Unlike pediatric acute lymphoblastic leukemia (ALL), which is curable in > 90% of cases, adult ALL has historically had a dismal prognosis, with limited treatment options and cure rates less than 40% [1, 2], due in part to higher-risk disease features in this population and significant chemotherapy-associated toxicity.B cell ALL accounts for approximately 75% of … That would be B … Around 800 people in the UK are diagnosed with ALL each year. That would be B cells or T cells. The phases of treatment are induction, central nervous system (CNS) therapy, intensification and … Epub 2019 Nov 7. Zhang D, Cheng Y, Fan J, Yao J, Zhao Z, Jiang Y, Li Y, Zuo Z, Tang Y, Guo Y. Most children with acute lymphoblastic leukemia (ALL) are cured on current first-line therapy plans. It is an acute leukaemia and can cause symptoms very quickly. In this disease, the body produces too many lymphoblasts (a type of white blood cell) and they become cancerous. These treatments are usually given 5 … With improvements in diagnosis and treatment, overall cure rates for children with acute lymphoblastic leukemia have reached 90%. Front Oncol. Clipboard, Search History, and several other advanced features are temporarily unavailable. Improved treatment for acute lymphoblastic leukemia (ALL) has virtually eliminated testicular relapse. Today, most protocols use high-dose methotrexate (combined with folinic acid rescue) together with 6-mercaptopurine (6-MP) and/or prolonged administrations of asparaginase in consolidation/intensification.1, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 64, 65, 66, 69, 70 Re-induction treatment mainly consists of a late repetition of the initial remission induction and early intensification … For acute lymphoblastic leukemia (ALL), the 5-year survival rate has improved significantly since 1975. Fifty years ago a pediatric oncologist would have never considered using the term "cure" in a discussion with a family whose child was diagnosed with ALL. This site needs JavaScript to work properly. 2020 Jan 23;135(4):252-260. doi: 10.1182/blood.2019000813. Standard treatment of recurrent childhood acute lymphoblastic leukemia (ALL) for leukemia that comes back in the bone marrow may include the following: Combination chemotherapy. Acute lymphoblastic leukemia/lymphoblastic lymphoma (ALL/LBL) is the most common childhood malignancy. St. Jude was the first hospital in the U.S. to remove cranial irradiation from treatment for ALL (and, later, for acute myeloid leukemia and non-Hodgkin lymphoma) without harming survival rates. Your child’s doctor may suggest clinical trials that are studying new ways … The most common cause of treatment failure in childhood acute lymphoblastic leukemia (ALL) remains relapse, occurring in ∼ 15%-20% of patients. Learn more about newly diagnosed and recurrent ALL in this expert reviewed summary. The prognosis (chance of recovery) and treatment options depend on: A Nomogram for the Prediction of Progression and Overall Survival in Childhood Acute Lymphoblastic Leukemia. This article summarizes the current diagnosis and treatment of childhood acute lymphoblastic leukemia. Nowadays, as a result of these prolonged and well … Integrated bioinformatics analysis of the crucial candidate genes and pathways associated with glucocorticoid resistance in acute lymphoblastic leukemia. If the leukemia remains in remission after induction and consolidation, maintenance therapy can begin. About 3,000 children and teens younger than 20 are diagnosed with ALL each year in the United States. 2004 May 1;22(9):1696-705. doi: 10.1200/JCO.2004.05.198. Learn about the acute lymphocytic leukemia … As an acute leukemia, ALL progresses rapidly and is typically fatal within weeks or months if left untreated. Acute lymphoblastic leukemia (ALL) is a cancer of the blood and bone marrow.It is the most common form of childhood cancer. Curr Opin Hematol. Symptoms may include feeling tired, pale skin color, fever, easy bleeding or bruising, enlarged lymph nodes, or bone pain. Information about treatment, survivorship, follow-up care, long-term and late effects, returning to school and ongoing research for childhood acute lymphoblastic leukemia (ALL). 2014 Mar 6;123(10):1470-8 Would you like email updates of new search results? Ultimately, more than 90 percent of patients are cured of the disease. A treatment clinical trial is a research study meant to help improve current … … In children, acute lymphoblastic leukemia starts in the uterine life, when genes become defective in the bone marrow. Cancer Med. Other treatments you may need include antibiotics and blood transfusions. Survival of children with acute lymphoblastic leukemia (ALL) is often described as the success story for oncology. Chen Y, Jiang P, Wen J, Wu Z, Li J, Chen Y, Wang L, Gan D, Chen Y, Yang T, Lin M, Hu J. If this does not happen and leukemia cells are present in the testicles at the end of Induction therapy, then radiation therapy to the testicles may be needed. 2020 Apr;9(8):2918-2929. doi: 10.1002/cam4.2934. Maintenance therapy. 2019 Oct;7(10):e00933. -, Lancet Oncol. … We have previously reported that patients with acute lymphoblastic leukemia in whom asparaginase treatment was discontinued because of … Also called post-remission therapy, this phase of treatment is aimed at destroying any remaining leukemia in the body, such as in the brain or spinal cord. Copyright © 2021 Elsevier B.V. or its licensors or contributors. Treatment often lasts two to three years, although the first months are the most intense. The goal of this phase is to kill as many leukemia cells in the blood and bone marrow as possible. After the European approval for the treatment of R/R Ph-negative ALL, blinatumomab has been made available to patients via an expanded access program. With a pre-leukemic clone, the body usually activates leukemia in children with a defective immune … ALL has one of the highest cure rates of all childhood cancers. ; Leukemia may affect red blood cells, white blood cells, and platelets. Asparaginase is an expensive drug, but important in childhood acute lymphoblastic leukemia. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. 1 A hyperdiploid karyotype with more than 50 chromosomes (particularly those with trisomies for 4, 10, 17, 18) identifies patients with a favorable outcome. We use cookies to help provide and enhance our service and tailor content and ads. Acute lymphoblastic leukemia (also called acute lymphocytic leukemia, or ALL) in children is cancer of the blood that starts in the bone marrow and spreads to the bloodstream. Here we review advances in the understanding of prognostic factors and their application. 2016 Jan;101(1):68-76 Today the term … In addition, treatment for leukemia will include most of the following: Chemotherapy.  |  Watch this video. Extraordinary advances in the treatment outcome of childhood acute lymphoblastic leukemia (ALL) rank as one of the most successful stories in the history of oncology, with the current rate of approximately 80% of children being cured [1-5]. … It usually needs to be treated as soon as possible after diagnosis. Approximately 6000 cases of acute lymphoblastic leukemia (ALL) are diagnosed in the United States annually; half the cases occur in children and teenagers. Ploidy is a highly significant prognostic factor in childhood acute lymphoblastic leukemia (ALL). Acute lymphoblastic leukemia (acute lymphocytic leukemia, ALL) is a malignant (clonal) disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoietic cells of the marrow. Studies in ALL have been a model for clinical and basic research beyond pediatric hemato-oncology. This is called a pre-leukemic clone, and it causes leukemia when these genes become activated, which only happens in 1% of the population with a pre-leukemic clone. Acute lymphoblastic leukemia (ALL), sometimes called acute lymphocytic leukemia, is the most common form of leukemia found in children, accounting for about 30 percent of all pediatric cancer. Nowadays, as a result of these prolonged and well-organized research efforts, childhood ALL can be successfully treated in about 80% of patients by the Leukemia starts in the bone marrow, the spongy internal part of bones where new blood is made. -, Br J Haematol. As an acute leukemia, ALL progresses rapidly and is typically fatal within weeks or months if left … The improvements made have been All children with acute lymphoblastic leukemia receive intrathecal chemotherapy given into the spinal fluid during a lumbar puncture. 2009 Feb;10(2):147-56 Adding bortezomib to standard reinduction chemotherapy in relapsed and refractory pediatric ALL has produced very good … Sometimes a stem cell transplant may also be needed to achieve a cure. Treatment of recurrent ALL depends on many factors, including the type of treatment the child received originally, the length of time between the initial diagnosis and the recurrence, and whether leukemia cells are found in the bone marrow, CSF, testicles, or in more than 1 of these sites when it recurs. Survival of relapsed patients can be predicted by site of relapse, length of first complete remission, and immunophenotype of relapsed ALL. As a result of sustained and well-organized research efforts since the early 1960s, childhood ALL now can be successfully treated in about 80% of patients by the application of intensive combination chemotherapy regimens, which in specific patient subgroups may need to be supplemented with radiation therapy and/or hematopoietic stem cell transplantation. Induction therapy. As a result of sustained and well-organized research efforts since the early 1960s, childhood ALL now can be successfully treated in about 80% of patients by the application of … Although the overall cure rate of acute lymphoblastic leukemia (ALL) in children is about 80 percent, affected adults fare less well. Radiation therapy, targeted therapy and stem cell transplant are sometimes used. Leukemia starts in the bone marrow, the spongy internal part of bones where new blood is made.