In the June issue of ONCOLOGY, authors McGregor et al did an admirable job of reviewing childhood cancer advances and current issues in their article entitled "Pediatric Cancers in the New Millennium: Dramatic Progress, New Challenges" (21:809-820, 2007). While the review by Arceci points out the notable lack of discussion about acute myelogenous leukemia (AML), another omission of great importance is the role of allogeneic transplant in the progress achieved in pediatric cancer treatment.
Passing mention is made of autologous rescue for Hodgkin's lymphoma, and of multiple autologous transplants in the treatment of neuroblastoma, but allogeneic transplant has played a major role in attaining the cure rates seen for other malignancies presented within the parent article. Allogeneic transplant is indicated for high-risk acute lymphoblastic leukemia (ALL) in the Total 15 protocol used at the authors' institution, and has been moderately successful in treating various forms of chemorefractory leukemias. If we are to improve upon existing outcomes, it will not come about without transplant, and not without giving as much attention to improved transplant methodologies as to the chemotherapeutic agents highlighted in the article.
—Name Withheld by Request
1. Pui CH, Evans WE: Treatment of acute lymphoblastic leukemia. N Engl J Med 354:166-178, 2006.
2. Chen X, Hale GA, Barfield R, et al: Rapid immune reconstitution after a reduced-intensity conditioning regimen and a CD3-depleted haploidentical stem cell graft for paediatric refractory haematological malignancies. Br J Haematol 135:524-532, 2006.