Pediatric leukemia remains a significant challenge in oncology, despite advancements in diagnosis and treatment. The heterogeneity of the disease and disparities in outcomes across demographic and socioeconomic factors underscore the need for continued research and improved strategies. This review examines recent developments in diagnostic techniques and treatment approaches for pediatric leukemia, focusing on acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Diagnostic techniques have evolved to include minimal residual disease (MRD) detection using flow cytometry, qPCR, and next-generation sequencing (NGS), improving sensitivity and accuracy in detecting leukemic cells. Novel imaging technologies and spectroscopy techniques offer non-invasive alternatives for visualizing leukemic cells and detecting central nervous system (CNS) involvement. Genomic analysis has enhanced prognostic prediction and enabled risk-adjusted chemotherapy, reducing relapse rates. Treatment strategies have shifted towards more targeted and personalized approaches, with immunotherapy, particularly chimeric antigen receptor (CAR-T) cell therapy, showing promise for refractory or relapsed cases. Targeted therapies like tyrosine kinase inhibitors have been integrated into standard protocols for specific genetic subtypes. Novel agents such as venetoclax, menin inhibitors, and homoharringtonine are being explored, with the latter showing improved remission rates and survival when used in induction therapy. Future research should focus on addressing challenges such as data variability, model scalability, and unequal access to advanced technologies. Continued innovation is essential to expand the use of these diagnostic and treatment methods globally. Overcoming cost and infrastructure barriers, particularly in low- and middle-income countries (LMICs), will be crucial for the widespread application of these advancements in pediatric leukemia care.

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