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Currently, acute leukemia in children is managed by applying risk-adaPted therapy.This approach requires the use of various methods to detect particular chromosomal abnormalities, one of the most important factors in allocating patients to risk groups.FISH has become a routine method for confirming specific chromosomal abnormalities observed by conventional eytogenetics and for defining abnormalities when conventional eytogenetie analysis is unsuccessful.With the advent of commercially available prelabeled probes, FISH can be used by most clinical cytogenetics laboratories to reliably detect the relevant diagnostic and prognostic chromosomal abnormalities in most children with acute leukemia.An important adjunct to FISH is RT-PCR, which is another powerful method for evaluating genetic lesions resulting in chimeric gene fusions.RT-PCR is also one of the most sensitive tests available for evaluating gene fusions at diagnosis and the presence of minimal residual disease (MRD) after therapy.