Milestones in the curability of pediatric cancers.

Progress in the study and treatment of childhood cancer is arguably the most remarkable and rewarding story of cancer therapy in the past five decades. During this time, five-year survival rates have steadily increased and now exceed 80% in developed countries for all pediatric cancer sites (Fig 1). With the expectation of extended survival into adulthood for most childhood patients with cancer, clinicians and researchers have concentrated considerable attention on optimizing the quality of long-term survival for diseases that largely respond to cytotoxic agents and modalities injurious to normal tissues. In this recollection of that progress, we shall touch on advances common to many childhood cancers but focus primarily on childhood leukemia because it has been the bellwether of scientific and therapeutic advances in many tumors, it encompasses many novel ideas in patient care during and after therapy, and it has influenced the study and treatment of adult cancers as well.