Treatment-related leukaemia - a clinical and scientific challenge

The development of a second tumour including treatment-related leukaemia (T RL), is the most devastating complication of intensive cancer chemotherapy. This is especially relevant in the paediatric population as over 70% of ch ildren diagnosed with a malignancy will now live at least 5 years. Most TRL s are myeloid leukaemias and carry an overall poor prognosis when compared with their de novo counterparts Despite the well known association with spe cific cytotoxic agents, improved understanding of-the pathogenesis and risk factors of TRL is ultimately essential if we are to develop successful str ategies for prevention and treatment. Here we review these aspects, togethe r with the clinical and diverse biological features of this complication an d the efficacy of current therapy. (C) 2000 Harcourt Publishers Ltd.