Acute lymphoblastic leukaemia (ALL) is the most common leukaemia in children and third most common in adults. Although the majority of children and adults with ALL achieve a complete remission with intensive chemotherapy, relapse will occur in 20% and 50% respectively. As further intensification risks greater toxicity and may not diminish the risk of relapse, new targeted therapies with less overall toxicity are urgently needed. There have been a number of new agents recently developed directed at specific cellular pathways involved in leukaemia genesis and are beginning to make their way into early phase clinical trials. This review will highlight a number of these novel chemotherapy agents and the pathways they target in relapse ALL.
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