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Leukemia Research Group

Children with leukemia

Acute leukemia is the most frequent cancer of childhood. The two main forms, acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML), account for more than one quarter of all cases of childhood cancer.

Decades of research have achieved significant advances in leukemia treatment. For example, the probability of survival for a child diagnosed with AML has increased from 35 per cent to 50-60 per cent over the past twenty years. For some forms of ALL, the probability of long term survival is approaching 80 per cent. Despite this greatly improved outlook for children with leukemia, current therapies for childhood leukemia treatment have reached their peak effectiveness. Most drugs in current use were designed in the 1960s, with few major additions to the treatment arsenal since the late 1970s. Most clinical research has focused on the doses and schedules for administering the existing drugs rather than testing new, innovative therapies. Unfortunately, 40-60 per cent of children with AML and 20-30 per cent of children with ALL are not cured with existing chemotherapy. In these cases, despite an initial response to treatment, the leukemia recurs and the prospects of subsequent cure become very low.

A critical limitation is that the available leukemia treatments lack specificity for leukemic cells. None of the current treatments for pediatric ALL and AML, including multi-agent chemotherapy, irradiation and bone marrow transplantation, limit effects to the abnormal, leukemia cells. Thus, side effects to normal cells and tissues in the body are common and can cause life-threatening acute complications, as well as long-term effects on health and wellbeing that extend into adulthood.

The key to developing better, more specific leukemia treatment is a better understanding of the molecular events and the blood/bone marrow cell targets that underlie the initiation and progression of leukemia. This type of knowledge will accelerate development of new strategies to disrupt the specific cellular and molecular processes that lead to the establishment and expansion of leukemic cells.