Behandeling van acute lymfatische leukemie bij kinderen en adolescenten: Zijn we er bijna?

Acute lymphoblastic leukaemia (ALL) is the most prevalent type of cancer in patients under the age of 18 years. Treatment of ALL consists of chemotherapy for a period of 2 years. Bone marrow transplantation and radiotherapy are indicated in only very few patients. The most important chemotherapeutic agents for the treatment of ALL are glucocorticoids (dexamethasone, prednisone), vincristine, asparaginase, methotrexate and 6-mercaptopurine. The cure rate of patients under the age of 18 years has increased from almost zero to > 80% in the past 40 years. Prognostically important factors are age at diagnosis, genetic abnormalities in the leukaemic cells and initial response to therapy. Adolescents with ALL have a much better prognosis when treated according to the protocol for children with ALL rather than the protocol for adults. It is anticipated that genomic research will lead to better classification and to more personalized therapy for individual patients.