Contributions of Pediatric Hematology/Oncology to the Diagnosis, Treatment, and Cure of Acute Lymphoblastic Leukemia: Part 2a (Numbers 11 to 15)

Pediatric hematology/oncology as a subspecialty has made major contributions to the diagnosis and treatment of acute lymphoblastic leukemia, the most common malignancy in the pediatric population. This impressive progress has yielded complete response rates of 98%, median durations of complete continuous remissions of over 5 years, and long-term leukemia-free survival and probable cure in 80% to 85% of patients. Sixty-five years ago, such data could only be imagined as future goals. This offering, part 2 of a planned trilogy, represents the second historical review from an admittedly elderly investigator, proud to have witnessed firsthand many of these advances. Part 2a contains numbers 11 to 15 and Part 2b consists of numbers 16 to 20. In consecutive order from the first 10: (11) more clues to the causation of ALL relating to in utero events and after birth, very early responses to infection; (12) the superiority of pediatric-inspired ALL trials for adolescents and young adults; (13) L-asparaginase; (14) chimeric antigen receptor T-cell therapy (CART); and (15) aggressive multiagent therapy for high-risk ALL introduced by BFM and CCG. My involvement with colleagues in some of these advances has provided a 65-year odyssey and its accompanying gratification and sense of accomplishment. Mostly, our goals have been achieved and have benefitted substantially our patients.