Childhood leukaemia: an update

Acute leukaemia is the predominant cancer of childhood. Fortunately most sub-types of acute leukaemia affecting children now have high cure rates. Recent research has revealed considerable phenotypic and genotypic heterogeneity in all types of leukaemia. Stratification of treatment by phenotype, genotype and early treatment response combined with incorporation of more effective formulations of existing drugs into treatment protocols and better supportive care have contributed to the improved survival rates observed in the last few decades. Toxicity, immediate and late, remains a concern and innovative agents, including immune based approaches, might help improve efficacy and reduce the burden of therapy by replacing toxic elements of current treatment protocols. This review discusses how acute leukaemia occurs and presents and how improved stratification has led to changes in treatment and improved outcomes for children.