American Society of Hematology

Milestones in Pediatric Acute Lymphocytic Leukemia

An article on curing pediatric acute lymphocytic leukemia by Joseph V. Simone and these accompanying milestones were published in December 2008 as part of the special ASH anniversary brochure, 50 Years in Hematology: Research That Revolutionized Patient Care.

1948Sidney Farber treats leukemia with aminopterin, which blocks folic acid and becomes the first agent to cause remission in children with ALL.
1950George Hitchings and Gertrude Elion develop 6-mercaptopurine to block DNA metabolism and kill rapidly growing leukemic cells.
1950sThe first combination chemotherapy regimens are designed by Emil Frei, Emil Freireich, and James Holland.
1960s
Criteria are established for the diagnosis of ALL.
The phases of therapy become recognized as important: remission induction, intensification, central nervous system therapy, and continuation (maintenance) therapy.
New treatment drugs are introduced: vincristine, asparaginase, cytoxan, daunomycin, and cytosar.
1970s

Donald Pinkel develops a "total therapy" approach to prevent a relapse of the cancer in patients' central nervous systems (leukemic meningitis).
Supportive care, such as platelet transfusions and antibiotics, improve patient outcomes.
1975For the first time, ALL is classified into subtypes for better treatment strategies.
1980s

About 50 percent of ALL patients become long-term survivors in much of the U.S. and Western Europe.
Cytogenetics (the study of chromosomes and cell division) emerges as a key tool in predicting outcome in ALL.
1998Researchers begin individualizing the dosage of chemotherapy to increase survival rates in children with ALL.
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