CHILDHOOD LEUKEMIA AS A MODEL FOR CANCER-RESEARCH - RICHARD-AND-HINDA-ROSENTHAL-FOUNDATION AWARD LECTURE

Abstract

Childhood acute lymphocytic leukemia (ALL) is a model for the study of disseminated cancer. It is always disseminated and relatively uniform, it is accessible to repetitive tissue sampling, and there is highly effective chemotherapy for it. The 1st systematic, controlled trials of cancer therapy were designed for patients with ALL by physicians attempting to cure a hopeless disease. The concept of leukemia cell subpopulations in each patient received major clinical support from ALL. The pharmacological sanctuary, typified by the meninges, was first discovered and specifically attacked in ALL. Combination therapy, aggressive therapy during remission, phase-specific therapy and the interrelationships of phases of therapy were developed first in ALL. Since leukemia cell features, such as T[thymus-derived]-cell characteristics, correlate with responsiveness to therapy, powerful new tools may be developed to improve the biological specificity of therapy. The results of therapy over the past 2 decades are gratifying. Childhood ALL continually offers opportunities for biological research and improved therapy for ALL and other forms of disseminated cancer.