Abstract
The past 20 years of curative therapeutics of childhood acute leukaemia has been largely a period of consolidation of gains, refinement of techniques and dissemination of expertise and technology. However, certain lessons have been learned. First, cure can be permanent but the complexity and cost of curative treatment currently restricts its accessibility; prevention or simple curative treatment is needed. Secondly, cure of the child demands that the risk of adverse sequelae of treatments be carefully balanced with known therapeutic benefits. Thirdly, preventive meningeal irradiation is no longer required. Fourth, treatment intensification is self-limiting. Adverse reactions can cancel out or exceed therapeutic benefits, resulting in a lower cure rate or a similar cure rate with lower quality of cure. Finally, morphology, immunophenotype and genotype of acute leukaemia are important criteria for selecting and scheduling drug therapy. Genotype may be the most important since leukaemia is a genetic disorder for which morphology and immunophenotype are mere reflections. However, none of these features, individually or together, are sufficient to explain all the difference in outcome among children on a given treatment plan or to completely fulfill the need of criteria for selection of treatment. Acute leukaemia remains an unsolved problem demanding considerably more basic and clinical research to meet the need for prevention and simple dependable curative treatment.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 24 print issues and online access
$259.00 per year
only $10.79 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pinkel, D. Lessons from 20 years of curative therapy of childhood acute leukaemia. Br J Cancer 65, 148–153 (1992). https://doi.org/10.1038/bjc.1992.32
Issue Date:
DOI: https://doi.org/10.1038/bjc.1992.32
This article is cited by
-
Infection, immune responses and the aetiology of childhood leukaemia
Nature Reviews Cancer (2006)
-
Childhood cancer-challenges and opportunities
The Indian Journal of Pediatrics (2003)
-
An odyssey in search of a cure: The evolution of treatment of childhood acute lymphoblastic leukemia in the United Kingdom
The Indian Journal of Pediatrics (1993)