Glucocorticoid resistance in paediatric acute lymphoblastic leukaemia

Abstract Glucocorticoids (GCs), such as prednisolone and dexamethasone, are key components in multi‐agent chemotherapy protocols used for the treatment of acute lymphoblastic leukaemia (ALL). Approximately 10% of children with ALL will respond poorly to GCs, and GC resistance is associated with a significantly inferior outcome. This review summarises the current knowledge of GC resistance in ALL, including the roles of the GC receptor and its co‐chaperone molecules, the pro‐apoptotic and pro‐survival B‐cell lymphoma 2 family members and alternative non‐apoptotic mechanisms of cell death. It concludes with a discussion on therapeutic attempts to overcome GC resistance.