Relapsed or refractory pediatric acute lymphoblastic leukemia: Current and emerging treatments

Alissa Martin, Elaine R Morgan, Nobuko Hijiya*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


Relapsed acute lymphoblastic leukemia (ALL) represents a major cause of morbidity and mortality in pediatrics. With contemporary chemotherapy, >85 of patients with newly diagnosed ALL survive. Unfortunately, 20 of these patients will relapse and for these children, outcomes remain poor despite our best known chemotherapy protocols. Most of these children will achieve a second complete remission, but maintaining this remission remains difficult. Because relapsed ALL is such a significant cause of morbidity and mortality, it is the focus of much research interest. Efforts have been made and continue to focus on understanding the underlying biology that drives relapse. The role of hematopoietic stem cell transplantation in relapsed ALL remains unclear, but many clinicians still favor this for high-risk patients given the poor prognosis with current chemotherapy alone.It is important to use new drugs with little cross-resistance in the treatment of relapsed ALL. New classes of agents are currently being studied. We also discuss prognostic factors and the biology of relapsed ALL. Adis

Original languageEnglish (US)
Pages (from-to)377-387
Number of pages11
JournalPediatric Drugs
Issue number6
StatePublished - Oct 17 2012


  • Acute-lymphoblastic-leukaemia
  • Acute-myeloid-leukaemia
  • Anthracyclines
  • Antineoplastics
  • Asparaginase
  • Bortezomib
  • Children
  • Clofarabine
  • Cyclophosphamide
  • Cytarabine
  • Dasatinib
  • Doxorubicin
  • Etoposide
  • Glucocorticoids
  • Histone-deacetylase- inhibitors
  • Idarubicin
  • Ifosfamide
  • Mercaptopurine
  • Methotrexate
  • Methyltransferase-inhibitors
  • Mitoxantrone
  • Nelarabine
  • Nilotinib
  • Prednisone
  • Proteasome-inhibitors
  • Toll-like-receptor-9-agonists
  • Transplantation
  • Vinca-alkaloids
  • Vincristine
  • mTOR-protein-inhibitors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pharmacology (medical)


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