Journal of Blood Disorders & Transfusion

Updates in pediatric acute lymphoblastic leukemia (ALL): Past, present and look to the future

5^th World Hematologists Congress

August 18-19, 2016 London, UK

Suleimman Alsweedan

King Faisal Specialist Hospital and Research Centre, KSA

Posters & Accepted Abstracts: J Blood Disord Transfus

Abstract:

Officially diagnosed in 1845, four types of leukemia were classified in 1913. Historically, it was treated with arsenic as mentioned by Hippocrates (460-370 BC). A fatal disease with survival of a few months, found the ray of hope in 1950 wherein Farber successfully brought a brief remissions using ACTH. In late fifties, first systematic chemotherapy trials were conducted and five years survival of 3% was achieved. First confirmed cure of leukemia was seen in early 70�??s and in last decade of 20th century, 70% cure rates were observed. CCG studies discovered the benefits of escalating dose intensity and addition of steroids in Induction and Re- Induction therapy. The focus was then shifted towards decreasing toxicity and late effects of the therapy. CCG-1961 was the first highrisk ALL trial in CCG to eliminate cranial radiation for all rapid early responder patients. With this, concept of tailoring the intensity of the treatment according to the risk of relapse started finding its roots. For very high risk group, stem cell transplantation emerged as the treatment of choice. Genomic profiling which helped improving risk stratification also alluded effectiveness of tyrosine kinase inhibitors in HR/VHR groups. We have successfully achieved cure rates of more than 80%. Interim analyses from various studies indicate a possible improvement to 90-95% in certain subgroups. Data on clinical features present at diagnosis and particular sentinel cytogenetic and/or molecular abnormalities is vital in establishing the new risk classification algorithm for finding the high quality cure in nearly all children with ALL.

Biography :

Email: salsweedan@kfshrc.edu.sa