Rationale and design of Total Therapy Study XV for newly diagnosed childhood acute lymphoblastic leukemia

摘要: The current cure rate of 80% in childhood acute lymphoblastic leukemia (ALL) attests to the effectiveness risk-directed therapy developed through well-designed clinical trials. ongoing Total Therapy Study XV at St. Jude Children's Research Hospital was designed further increase and improve quality life. study consists intensive systemic intrathecal but does not include cranial irradiation, irrespective a patient's risk features. intensity postremission consolidation, continuation reinduction is based on level minimal residual disease end induction, as measured by both flow cytometric detection aberrant immunophenotypes polymerase-chain-reaction amplification clonal antigen-receptor gene rearrangements. Status thiopurine methyltransferase determined prospectively for treatment modification. Pharmacogenetic, pharmacodynamic, expression proteomic profiling studies host normal cells leukemic are performed parallel elucidate mechanisms drug resistance advance our understanding leukemogenesis.