Fifty Years of Studies of the Biology and Therapy of Childhood Leukemia

Abstract

SINCE CHEMOTHERAPY beginnings 50 years ago by Farber and his colleagues, childhood leukemia treatment has been one of the most dramatic cancer success stories.1 Currently more than 70% of children with acute lymphoblastic leukemia are alive and disease-free at 5 years, probably making it the most successfully treated of the disseminated human cancers. Certain forms of acute childhood leukemia have a 90% probability of cure, yet there is a group that is still very therapy resistant. Concurrently, in recent years, our knowledge of the molecular and cellular biology underlying these pediatric leukemias has significantly increased. We are at the point where we can reasonably answer these questions: What are the reasons for childhood leukemia treatment success compared with other cancers? Why are certain subgroups of patients therapy-resistant while most patients have very therapy-sensitive disease? I believe that our knowledge of the molecular genetic abnormalities will provide the key to understanding the treatment successes and failures in childhood leukemia.