MANAGEMENT OF PEDIATRIC LEUKEMIA: INDUCTION, CONSOLIDATION, AND MAINTENANCE PHASES

Abstract

Acute leukemias represent the most prevalent neoplasm in childhood, with Acute Lymphoblastic Leukemia (ALL) accounting for the majority of cases. Contemporary treatment is structured into risk-stratified protocols and organized into sequential phases: remission induction, consolidation, and maintenance. Induction aims to eradicate most of the leukemic burden to achieve complete remission (CR), while consolidation focuses on eliminating Minimal Residual Disease (MRD), which is the main prognostic predictor. Maintenance, which is long-term, aims to prevent late relapse through low-intensity chemotherapy. Recent advances have enabled the progressive integration of targeted and immunological therapies (such as blinatumomab, daratumumab, and BCL-2 and menin inhibitors) into traditional regimens, contributing to increased cure rates and improved long-term prognosis. Current management requires the integration of structured protocols with precise biological stratification and continuous multidisciplinary support, aiming to maximize cure and reduce toxicity for the child.