Chemotherapieresistentie en 'minimal residual disease': Nieuwe mogelijkheden voor therapie op maat voor kinderen met leukemie?

Seventy-five % of children with acute lymphoblastic leukemia (ALL) are cured. The classical risk factors do not predict accurately which children will be cured and who will not. Recently two new methods have been developed that might be helpful to do so. These are the determination of the in vitro resistance of ALL cells at initial diagnosis and the measurement of in vivo treatment efficacy through the detection of minimal residual disease during the first phase of treatment. It is anticipated that the use of these techniques can lead to better risk group stratification for children with ALL. This might result in less toxicity for children who might be cured with relatively mild chemotherapy and on the other hand to better recognition of children who need intensive treatment to be cured.