Acute Lymphoblastic Leukemia -- Progress in Children, Less in Adults

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Abstract
In children with acute lymphoblastic leukemia (ALL), rates of complete remission ranging from 90 to 95 percent and rates of long-term disease-free survival approaching 70 percent can now be achieved. In this issue of the Journal, Rivera and colleagues1 show convincing improvement in disease-free survival, from 9 to 71 percent, over a period of nearly 30 years. The development of effective antileukemic combination chemotherapy, the introduction of prophylactic treatment for relapse of leukemia in the meninges, and recent, more aggressive strategies involving the earlier use of intensive therapy (thereby probably avoiding multidrug resistance) are among the reasons for this success. . . .