How I treat Infant Leukemia

Infant leukemia is one of most difficult clinical situations encountered in pediatric hematology/oncology.

Recent discoveries regarding the unique biology of these leukemias are fueling the development of a pipeline of exciting novel treatment strategies that are increasingly being incorporated into clinical trials and have the potential to reduce both relapse rates and treatment-related toxicities.

Leukemia in infants is rare but generates tremendous interest due to its aggressive clinical presentation in a uniquely vulnerable host, its poor response to current therapies, and its fascinating biology.

Increasingly, these biological insights are pointing the way toward novel therapeutic approaches. Using representative clinical case presentations, we review the key clinical, pathologic, and epidemiologic features of infant leukemia, including the high frequency of KMT2A gene rearrangements. We describe the current approach to risk-stratified treatment of infant leukemia in the major international cooperative groups.

We highlight recent discoveries that elucidate the molecular biology of infant leukemia and suggest novel targeted therapeutic strategies, including modulation of aberrant epigenetic programs, inhibition of signaling pathways, and immunotherapeutics.

Increasing collaboration among the major international cooperative groups will accelerate the translation of biological understanding into better outcomes.

Read the full article published on Sept. 23rd, 2019 in the blood journal:

How I treat infant leukemia Full Article

Scientists:

Andrea Biondi, Department of Pediatrics and Centro M. Tettamanti, University of Milano-Bicocca, Italy;
Patrick Brown, Department of Oncology and Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore;
Rob Pieters , Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands;