Over 90 Percent of Children With Acute Lymphoblastic Leukaemia Can Be Cured With Current Treatments: Indian Researchers Suggest
India: Advances in precision medicine, molecular diagnostics, and immunotherapy are improving survival outcomes in children with acute leukaemia, with current treatment approaches expected to cure more than 90% of children with acute lymphoblastic leukaemia (ALL). However, the high cost of newer therapies remains a major barrier to accessing these treatments, particularly for families with limited financial resources, according to Dr Amita Mahajan, Paediatric Haematology, Oncology and BMT Unit, Indraprastha Apollo Hospitals, New Delhi.
“Recent advances in diagnosis and risk stratification have enabled us to identify more precisely which patients require intensive treatment and which can be cured with less intensive regimens, thereby reducing short-term and long-term toxicity,” Dr Mahajan told Medical Dialogues.
These insights are part of her review, “Paediatric Acute Leukaemia: Management in the Era of Precision Medicine and Immunotherapy,” published in Apollo Medicine.
Acute leukaemia is the most common childhood malignancy and primarily comprises ALL and acute myeloid leukaemia (AML). Advances in understanding disease biology, molecular testing, treatment-response monitoring and supportive care have substantially improved outcomes, although the prognosis and treatment challenges differ between these two conditions.
The review examined contemporary developments in the diagnosis, risk classification and treatment of paediatric acute leukaemia, highlighting the growing role of genomic profiling, measurable residual disease (MRD) assessment, targeted therapies and immunotherapy.
The major findings and developments include:
- Improved survival in ALL: Contemporary treatment protocols have raised survival rates above 90% in specialised centres, making childhood ALL one of the major success stories in modern oncology.
- More personalised treatment: Molecular diagnostics and MRD monitoring help clinicians assess treatment response and identify children who may benefit from more intensive or less intensive therapy.
- New options for difficult-to-treat disease: Immunotherapeutic agents, including blinatumomab, inotuzumab and chimeric antigen receptor (CAR) T-cell therapy, have expanded treatment possibilities for patients with high-risk, relapsed or refractory ALL.
- Progress in AML management: Molecular characterisation and targeted therapies have contributed to improved outcomes, with five-year overall survival reaching approximately 70%–80% in tertiary care centres, although substantial challenges remain.
Discussing the impact of immunotherapy, Dr Mahajan told Medical Dialogues, “With these agents, we are now able to cure many patients with acute lymphoblastic leukemia who were considered incurable before.”
Despite these advances, affordability remains a significant concern. Dr Mahajan identified the high cost of newer treatments as the biggest obstacle to wider access. However, the availability of indigenous CAR T-cell therapies has helped reduce costs, while compassionate access programmes have enabled some patients to receive blinatumomab.
AML remains another major challenge, with treatment outcomes still falling short of those achieved in ALL. Ongoing research is exploring new approaches to improve survival in children with this disease.
Looking ahead, Dr Mahajan told Medical Dialogues that future efforts would focus on developing additional targeted therapies, improving their accessibility and introducing effective treatments earlier in the treatment pathway. Improving outcomes in paediatric AML will remain a key priority.
The review highlights the need to combine advances in precision medicine with affordable treatment, stronger supportive care, and wider access to specialised services so that more children can benefit from progress in leukaemia management.
Reference:
Bansal, M., & Mahajan, A. (2026). Paediatric Acute Leukaemia: Management in the Era of Precision Medicine and Immunotherapy. Apollo Medicine. https://doi.org/10.1177/09760016261471621
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