Acute lymphoblastic leukaemia in children and adolescents: chance of cure now higher than 80%

Conflict of interest: none declared. Financial support: none declared.

• Acute lymphoblastic leukaemia (ALL) is the most prevalent type of cancer in patients under the age of 18 years.

• Treatment of ALL consists of chemotherapy for a period of 2 years. Bone marrow transplantation and radiotherapy are indicated in only very few patients.

• The most important chemotherapeutic agents for the treatment of ALL are glucocorticoids (dexamethasone, prednisone), vincristine, asparaginase, methotrexate and 6-mercaptopurine.

• The cure rate of patients under the age of 18 years has increased from almost zero to > 80% in the past 40 years.

• Prognostically important factors are age at diagnosis, genetic abnormalities in the leukaemic cells and initial response to therapy.

• Adolescents with ALL have a much better prognosis when treated according to the protocol for children with ALL rather than the protocol for adults.

• It is anticipated that genomic research will lead to better classification and to more personalised therapy for individual patients.