ABSTRACT
Despite advances in the treatment of childhood acute lymphoblastic leukemia (ALL), relapsed ALL remains the third most common cancer in children. Because transplantation is frequently used as therapy for recurrent disease, ALL is one of the most common indications for transplantation in pediatrics. With improved frontline therapies for childhood ALL, there are fewer children presenting to transplant; but those who do are frequently more heavily pretreated and have more drug-resistant disease than those transplanted in earlier years. This makes the child with recurrent ALL one of the more challenging of transplant patients today. The theory behind transplantation is to destroy resistant leukemia cells with high-dose radiation therapy and chemotherapy and to generate a cellular graft-versus-leukemia (GVL) effect.
