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Relapsed Acute Lymphoblastic Leukemia of Childhood

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Childhood Acute Lymphoblastic Leukemia

Abstract

Relapsed ALL remains a major therapeutic challenge with little improvements in outcome over the last three-decades. In late relapsing BCP-ALL bone marrow disease, MRD has been employed to stratify for allogeneic stem cell transplantation (allo-SCT) or chemotherapy. In patients receiving an allo-SCT, the use of mitoxantrone may be associated with decreased relapse rates post SCT. Outcome for early relapsing patient is very poor except a the small minority of patients who become MRD low/negative at the end of re-induction. Early isolated extramedullary relapse has better outcomes that bone marrow relapses. In T-ALL patients with bone marrow relapse, little progress has been made over the last three decades. A better understanding of the biology of disease recurrence, targeted therapy and innovative approaches to allografts offers possible ways of improving outcomes in the coming decades.

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Authors and Affiliations

  1. Royal Manchester Children’s Hospital, Central Manchester University Hospitals NHS Trust, Manchester, M13 9WL, UK

    Su Han Lum, Denise Bonney & Vaskar Saha

  2. Children’s Cancer Group, Paterson Building, Institute of Cancer, University of Manchester, Manchester, M20 4BX, UK

    Vaskar Saha

  3. Tata Translational Cancer Research Centre, Tata Medical Center, Kolkata, 700156, India

    Vaskar Saha

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  1. Su Han Lum
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  2. Denise Bonney
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  3. Vaskar Saha
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Correspondence to Vaskar Saha .

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  1. Department of Paediatric Haemotology, Sheffield Children’s Hospital NHS Trust, University of Sheffield, Sheffield, South Yorkshire, United Kingdom

    Ajay Vora

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Lum, S.H., Bonney, D., Saha, V. (2017). Relapsed Acute Lymphoblastic Leukemia of Childhood. In: Vora, A. (eds) Childhood Acute Lymphoblastic Leukemia. Springer, Cham. https://doi.org/10.1007/978-3-319-39708-5_11

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