Pharmacogenomics of childhood acute lymphoblastic leukemia.

Approximately 80% of children with acute lymphoblastic leukemia (ALL) can be cured with modern therapy. Despite this success, the number of cases of relapsed ALL remains greater than the number of new cases of most childhood cancers. New strategies are needed to develop curative therapy for the 20% of patients who are not being cured today, and to develop less toxic and less onerous treatment for ALL patients. Molecular genetics has already provided important insights to the mechanisms of leukemogenesis and is now routinely used to define the prognosis and guide treatment intensity for childhood ALL. Pharmacogenomics is a burgeoning field that aims to elucidate inherited differences in drug disposition and treatment response, toward individualizing therapy to enhance efficacy and reduce toxicity. Herein, we review recent progress in thesefields as they relate to childhood ALL, and discuss the promise they hold to further enhance treatment of the most common cancer in children.