Treatment of Acute Lymphoblastic Leukemia

Acute lymphoblastic leukemia (ALL) affects both children and adults, with prevalence between the ages of 2 and 5 years. Serial clinical trials have resulted in steady improvement in the outcome of patients with ALL. Most children and over a third of adult patients are cured with widely available treatment approaches based on the use of risk-directed multiagent chemotherapy regimens and diligent supportive care. Ongoing research is now aiming at reducing long term treatment sequelaes in children and younger adults, and at improving the outcome of adults and some subgroups of children with poor prognosis. This review tracks six decades of progress in the therapy of ALL, summarizes the rational of contemporary ALL therapy, and addresses remaining challenges.