An accompanying Comment article notes that although the findings are generally reassuring, it is uncertain how transferable they are to present-day patients with standard-risk ALL, who could be at much higher risk of late effects than reported in this study. Firstly, patients classified with standard-risk disease in the current study differ significantly from today's patients. Second, wider use of dexamethasone, high-dose methotrexate, extensive treatment with asparaginase, and more intensive maintenance therapy with mercaptopurine and methotrexate might increase the risks of late effects, including chronic pancreatitis, diabetes, osteonecrosis, cognitive disturbances, and second cancers. Third, secondary myeloid malignancies—the most common second cancer—mainly take place within first 5 years from diagnosis, and these early events were not included. Finally, the risk of late effects that become apparent after age 40 years, including premature ageing, remains uncertain.