Table of Contents

HK J Paediatr (New Series)
Vol 1. No. 1, 1996

HK J Paediatr (New Series) 1996;1:31-36

Feature Article

Childhood Acute Lymphoblastic Leukaemia - Some Outstanding Issues

HP Lin


Even though the cure rate of childhood acute lymphoblastic leukaemia (ALL) has improved to about 70%, mainly because of early intensification of treatment, many outstanding issues remain. These include the feasibility of risk-adapted treatment, an ideal concept based on biological disease heterogeneity and contingent upon rigorous and reliable risk assignment. Until recently criteria for risk assignment are not uniform, making comparison of results difficult. Early intensification of treatment has improved the prognosis of both high and lower-risk patients. The benefit to high-risk patients are more obvious because these are easier to identify. While genuine lower-risk ALL patients do not need intensive treatment, many still receive such therapy, mainly because their risk criteria are not reliable. The best method of CNS directed treatment with the least neurotoxicity is still controversial. Regular intrathecal (IT) chemotherapy with or without IV methotrexate (MTX) has been increasingly used but its long term neuropsychological sequelae are uncertain.

Keyword : CNS directed treatment; Early intensification; Leukaemia; Risk-adapted treatment


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