A validated novel continuous prognostic index to deliver stratified medicine in pediatric acute lymphoblastic leukemia. Incorporating new genomic biomarkers and more sensitive measures of minimal/measurable residual disease provide opportunities to achieve these goals.Ĭlinical trials lymphoblastic leukemia precision medicine.Įnshaei A, O'Connor D, Bartram J, et al. Distinguishing those who require intensive or novel therapeutic approaches from others who will be cured with minimal therapy is key for future trials. Recently, numerous Children's Oncology Group trials have demonstrated the lack of benefit of intensifying traditional chemotherapy, providing evidence that new approaches are needed to cure the patients for whom cure has been elusive.

This is due to intensifying systemic therapy, recognizing and treating the central nervous system as a sanctuary site, and implementing modern risk stratification to deliver varying intensities of therapy based on age, presenting white blood count, sentinel somatic genetics, and therapy response. 9 Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA.Ĭure rates for acute lymphoblastic leukemia (ALL), the most common childhood cancer have steadily improved over the past five decades.

8 Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, Washington, USA.

7 Children's Hospital of Philadelphia Division of Oncology, Center for Childhood Cancer Research, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.

6 Division of Pediatric Hematology/Oncology, Texas Children's Cancer Center, Baylor College of Medicine, Houston, Texas, USA.

5 Department of Pediatrics, Center for Cancer and Blood Disorders, Children's Hospital of Colorado, The University of Colorado School of Medicine, Aurora, Colorado, USA.

4 Department of Global Medicine, St Jude Children's Research Hospital, Memphis, Tennessee, USA.

3 Department of Biostatistics, St Jude Children's Research Hospital, Memphis, Tennessee, USA.

2 Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California Norris Comprehensive Cancer Center and Keck School of Medicine, Los Angeles, California, USA.

1 Department of Pediatrics, Perlmutter Cancer Center, New York University Langone Health, New York, New York, USA.

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