By Ching-Hon Pui
Pui (U. of Tennessee overall healthiness technology heart) provides forty two papers which are dedicated to picking and discussing pivotal matters that will be resolved via greater functions of present tools of leukemia administration, instead of expecting laboratory discoveries to force switch. Chapters examine
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Pui (U. of Tennessee healthiness technology middle) provides forty two papers which are dedicated to selecting and discussing pivotal matters that would be resolved via higher functions of present equipment of leukemia administration, instead of looking ahead to laboratory discoveries to force swap. Chapters examine
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Extra resources for Treatment of acute leukemias : new directions for clinical research
It has to be kept in mind that treatment itself influences the impact of prognostic parameters. The major objective for the future is to find the best therapy for each biologic entity. To reach this objective, the biologic entities have to be clearly defined, and large well-designed prospective trials are needed to allow a randomized comparison of different treatment strategies even in small subgroups. For APL, this goal has already been achieved. There is worldwide agreement to treat this subgroup of patients within separate trials, implementing ATRA.
Near-Triploidy and Near-Tetraploidy Near-triploidy and near-tetraploidy are more frequent in adult ALL than in childhood ALL. Although near-triploidy seems to be associated with a poor outcome, the prognosis associated with near-tetraploidy is in the range of that conferred by a normal karyotype. These data have to be interpreted cautiously because the number of reported cases is still small. 6. Single Chromosome Gains and Losses The incidence of a trisomy or monosomy as the only karyotypic anomaly in ALL is low.
4. Hyperdiploidy >50 Chromosomes Chromosome numbers cluster around 51–55. There seems to be a certain pattern of gained chromosomes. Frequently gained chromosomes are 4, 6, 8, 10, 14, 17, and 21. About half of all childhood and adult ALL cases with hyperdiploidy >50 show additional structural chromosomal rearrangements, with t(9;22)(q34;q11) being the most common in adults (353). In children with ALL, a modal number between 51 and 55 is associated with a favorable prognosis. The combination of trisomies of both chromosomes 4 and 10 with hyperdiploid ALL identifies a subgroup of patients with an extremely favorable outcome and a strong likelihood of cure with antimetabolitebased chemotherapy (353).