In conclusion, in approximately 20% of initial and relapsed childhood ALL, the sensitive and rapid assessment of the kinetics of leukemic cell reduction during induction therapy and in morphological remission by nested RT-PCR of leukemia-specific TEL-AML1 fusion transcripts allows a distinction among TEL-AML1 positive ALL. The fast reduction of TEL-AML1 positive blast cells in a majority of children with initial or relapsed TEL-AML1+ALL below the detection limit of nested RT-PCR seems to be a prerequisite for long-term CR,allowing a better determination of relapse risk and a more appropriate treatment stratification.