Outcomes after Induction Failure in Childhood Acute Lymphoblastic Leukemia

SUMMARY:In children and adolescents with acute lymphoblastic leukemia (ALL), allogeneic stem cell transplantation is usually considered the treatment option, after failure of remission-induction therapy. In their review of over 44,000 cases of pediatric ALL in three continents, the authors noted that patients with B-cell ALL had better outcomes when treated with a second round of chemotherapy without a transplant. Patients with T-cell ALL however were noted to have a better outcome with transplantation. This review suggests that induction failure in patients with ALL does not automatically warrant transplantation. Schrappe M, Hunger SP, Pui C, et al. N Engl J Med 2012; 366:1371-1381