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Acute lymphoblastic leukemia (ALL), the most commonly diagnosed pediatric cancer, has a high cure rate. Current research focuses on improving risk stratification of patients, developing targeted therapies, and minimizing use of treatments that have substantial long-term toxicity.
In part to assess whether cranial irradiation can be avoided without affecting survival in patients with childhood ALL, Dutch researchers stratified 859 ALL patients (age range, 1–18 years) into a non–high-risk group (601 patients) and a high-risk group (258 patients). The non–high-risk group received a three-drug regimen (dexamethasone, vincristine, and asparaginase [Elspar]) for 6 weeks, followed by medium-dose methotrexate for 3 weeks, and then maintenance therap…