Taking childhood leukemia personally

Abstract

The concept of biologic unity and the feasibility of "one-fits- all" treatment strategies has become outdated for most malignancies and certainly for acute lymphoblastic leukemia (ALL) of childhood. Conventionally defined malignant diseases represent a collection of molecularly distinct entities with characteristic features that define their response to treatment as well as their prognosis. Clinically significant heterogeneity of childhood ALL became apparent when disparity in treatment responses and differences in the cytogenetic makeup of leukemia cells were identified. Even today, with molecular subtyping of leukemias, these seemingly archaic features remain important components of the individual risk stratification of modern treatment protocols that allow us to successfully individualize treatment according to risk.