Improvements in outcome of childhood acute lymphoblastic leukaemia (ALL) in the UK - a success story of modern medicine through successive UKALL trials and international collaboration

Sixty years ago, there was no expectation of cure for children with acute lymphoblastic leukaemia (ALL) and treatment was essentially palliative. In the year 2020, >90% of children and >70% of young adults can expect to be cured with first-line therapy and 20-50% of relapses can be salvaged depending on age and timing of relapse. The focus of treatment is gradually shifting from intensive therapy to the use of new agents to optimise efficacy, while minimising acute and long-term toxicity. The UKALL trials have made important contributions to the refinement of treatment stratification and scheduling, which have delivered the excellent outcomes to date without new agents. This year UKALL, with other groups across Europe, will begin a new collaborative group working from a unified ALL protocol (ALLTogether) that will incorporate new agents including immune-based approaches.