18. Childhood lymphoblastic leukemia commentary

  1. Ross Pinkerton MB, BCh, BaO, MD Executive Director, Division of Oncology2,
  2. Ananth Shankar MD, FRCPCH Consultant in Paediatric and Adolescent Oncology3 and
  3. Katherine K. Matthay BA, MD Mildred V. Strouss Professor of Translational Oncology, Director, Pediatric Hematology-Oncology4
  1. Vaskar Saha

Published Online: 8 MAY 2013

DOI: 10.1002/9781118625309.ch18

Evidence-Based Pediatric Oncology

Evidence-Based Pediatric Oncology

How to Cite

Saha, V. (2013) Childhood lymphoblastic leukemia commentary, in Evidence-Based Pediatric Oncology (eds R. Pinkerton, A. Shankar and K. K. Matthay), John Wiley & Sons, Ltd, Oxford. doi: 10.1002/9781118625309.ch18

Editor Information

  1. 2

    Royal Children's Hospital, Children's Health Queensland, Brisbane, QLD, Australia

  2. 3

    University College London Hospitals NHS Foundation Trust London, UK

  3. 4

    Department of Pediatrics, UCSF School of Medicine and, UCSF Benioff Children's Hospital, San Francisco, CA, USA

Author Information

  1. The University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, UK

Publication History

  1. Published Online: 8 MAY 2013
  2. Published Print: 20 MAY 2013

ISBN Information

Print ISBN: 9780470659649

Online ISBN: 9781118625309



  • acute lymphoblastic leukemia (ALL);
  • ASNase;
  • continuation therapy;
  • minimal residual disease (MRD);
  • postinduction therapy;
  • remission induction


The mainstream of therapies in childhood acute lymphoblastic leukemia (ALL) continues to be broad-spectrum and nonspecific chemotherapy. Fewer relapsed and refractory patients are available for early-phase clinical trials and clinicians are understandably anxious about introducing as yet unproven new agents into phase III trials. Perhaps the most significant developments with regard to therapy lie in the now routine use of minimal residual disease (MRD) in risk stratification and the push towards decreasing toxicity. The chapter discusses both these topics with quoted proceedings. Current evidence suggests that ASNase is a key drug in childhood ALL therapy and when used to provide optimal activity along with steroids, contributes significantly to outcome. The chapter also talks about postinduction therapy and continuation therapy. One recent report shows that MRD is the most sensitive predictor of outcome, superior to all other risk factors.