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Introduction and overview to issue on new developments in pediatric hematology/oncology.

DOI:10.1097/MOP.0000000000000178 Over the past five decades, remarkable advances have been made in the field of pediatric hematology/oncology as evidenced by the fact that 5-year overall survival rates for all pediatric cancers exceed 80% in developed countries [1]. However, much of this progress has come from careful empirically based investigation without insight into the underlying biology that drives many diseases. This is a very exciting time as breakthroughs in high throughput genomics now bring us to the cusp of ‘precision medicine’ [2,3]. With this expanding knowledge, there is optimism that cure rates and the quality of life for children with hematologic disorders and cancer will continue to improve. The articles in this issue highlight examples of recent progress and the potential impact, as well as the associated challenges, of the movement toward precision medicine for children with a spectrum of oncologic diseases and nonmalignant disorders. Metastatic sarcomas are very challenging to treat and survival rates have remained dismal despite the use of intensive therapy. Recent evidence suggests that metastatic sites of disease may have enhanced genomic instability and acquired chemotherapy resistance, and accordingly the survival for this group of patients may be enhanced by adopting local measures in combination with chemotherapy to eradicate distant sites of tumor. Daniel Lerman and R. Lor Randall (pp. 3–8) review the rationale and options for the local treatment of metastatic sites of disease in pediatric sarcomas and they describe an initiative within the Children’s Oncology Group to systematically evaluate this therapeutic approach. Shalini Shenoy and Jaap Boelens (pp. 9–17) describe recent progress and expanding therapeutic options in the use of hematopoietic stem cell transplantation (HCT) for a wide range of nonmalignant disorders. The role of HCT has expanded exponentially, especially with the availability of alternative stem cell sources. Additionally, innovative transplant methodology and enhanced supportive care measures have improved the safety and efficacy of this approach and increased curative options for these disorders. The authors provide a detailed overview of