Improvements in outcome of childhood acute lymphoblastic leukaemia (ALL) in the UK – a success story of modern medicine through successive UKALL trials and international collaboration

Abstract

SummarySixty years ago, there was no expectation of cure for children with acute lymphoblastic leukaemia (ALL) and treatment was essentially palliative. In the year 2020, >90% of children and >70% of young adults can expect to be cured with first‐line therapy and 20–50% of relapses can be salvaged depending on age and timing of relapse. The focus of treatment is gradually shifting from intensive therapy to the use of new agents to optimise efficacy, while minimising acute and long‐term toxicity. The UKALL trials have made important contributions to the refinement of treatment stratification and scheduling, which have delivered the excellent outcomes to date without new agents. This year UKALL, with other groups across Europe, will begin a new collaborative group working from a unified ALL protocol (ALLTogether) that will incorporate new agents including immune‐based approaches.

Income disparities between adult childhood cancer survivors and their peers—A register‐based cohort study from the SALiCCS research programme

“…We found that the risk for low income was highest in the earlier diagnostic periods from 1971 to 1999 with the gap partially disappearing in the most recent diagnostic period from 2000 to 2009. Past and ongoing clinical efforts to develop less toxic cancer treatment regimens may provide an explanation and suggest a possible decrease in the treatment burden of some childhood cancers 30 . One can also presume that better social support for patients and families may have also contributed to this development.…”

“…Past and ongoing clinical efforts to develop less toxic cancer treatment regimens may provide an explanation and suggest a possible decrease in the treatment burden of some childhood cancers. 30 One can also presume that better social support for patients and families may have also contributed to this development.…”

Linear and Circular Long Non-Coding RNAs in Acute Lymphoblastic Leukemia: From Pathogenesis to Classification and Treatment

“…Treatment of pediatric ALL represents a major success story and paradigm of malignant cancer elimination by dose-intensified chemotherapy regimens [28]. This is attributable to the improved risk stratification based on genetics as well as clinical characteristics at diagnosis, optimized chemotherapy regimens according to early treatment response as measured by minimal residual disease (MRD), and better tolerance of children to the chemotherapy regimens than adults [8,9,28,29]. However, relapsed ALL is still the second leading cause of childhood cancer-related death [18].…”

Targeting N-cadherin (CDH2) and the malignant bone marrow microenvironment in acute leukaemia

“…Leukaemia accounts for 31% of cancer diagnoses in children up to 14 years of age in the UK, of which 401 children are diagnosed with acute lymphoblastic leukaemia (ALL) and 79 with acute myeloid leukaemia (AML) per year (Ref. 1 ); overall, the 5-year survival of ALL and AML is over 90 and 67%, respectively (Refs 1 , 2 ). N-cadherin (CDH2) is a cell adhesion molecule that mediates adhesive interactions between leukaemia cells and the cells of the bone marrow (BM) (Refs 3 , 4 ).…”