History of the treatment of childhood ALL: a paradigm for cancer cure.

The history of the treatment of childhood leukemia from 1950 to the present is reviewed here. Particular emphasis is placed on the 'Total Therapy' studies conducted at St Jude Children's Research Hospital in Memphis, Tennessee. Under the guidance of Donald Pinkel, MD, the first medical director of St Jude, variations in chemotherapy and craniospinal irradiation were tried, and by Study XV, begun in 2000, a 4-year event-free survival of 92+/-7% had been achieved. Strengths and weaknesses in the current treatment of childhood leukemia are discussed as well as possibilities for the future.