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Acute Lymphoblastic leukemia in adults

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https://www.readbyqxmd.com/read/28728499/acute-central-nervous-system-complications-and-ammonium-levels-in-adult-patients-with-acute-lymphoblastic-leukemia-receiving-l-asparaginase
#1
Nicole Strickler, Stefan Balabanov, Katharina Casauro, Urs Schanz, Markus G Manz, Bernhard Gerber
We analyzed ammonium levels and acute central nervous complications in adult patients receiving chemotherapy for acute lymphoblastic leukemia with or without asparaginase (l-asp). Twenty patients with a median age of 40.3 years were included. Ammonium-levels were measured during 88 chemotherapy cycles, 60 cycles (68%) with l-asp, and 28 cycles (32%) without l-asp. Ammonium was elevated in 87% of all l-asp containing cycles, with median ammonium levels of 169 μmol/l (interquartile range (IQR) 91-269 μmol/l)...
July 21, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28726435/-acute-lymphoblastic-leukemia-of-adults-a-case-of-prolonged-hip-pain-diagnostics-with-a-surprising-conclusion-case-report
#2
Štěpán Hrabovský, František Folber, Barbora Jurová, Zdeněk Řehák, Michael Doubek
Though acute lymphoblastic leukemia (ALL) is the most common malignancy of childhood age, it is a rare diagnosis in adults. This disease often manifests with common and nonspecific symptoms, so it can easily escape an early diagnostics without a proper blood count examination. We present a case of an adult ALL patient suffering only from severe hips and thighs pain, without any significant blood count abnormities leading to the diagnostics. In the second part of the article, we summarize current highlights regarding this disease...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28722319/immunophenotypic-aberrancies-in-acute-lymphoblastic-leukemia-from-282-iraqi-patients
#3
S D Jalal, N A S Al-Allawi, A A S Al Doski
INTRODUCTION: The identification of aberrancies in leukemia-associated immunophenotype (LAIP) of acute lymphoblastic leukemia (ALL) is quite important in the assessment of minimal residual disease (MRD). This study, the first from Iraq, aimed to assess the frequency and patterns of LAIP among Iraqi patients with ALL, to establish future strategies for evaluating MRD. METHODS: A total of 282 newly diagnosed Iraqi ALL cases were analyzed with six-parameter flow cytometry using a panel of 29 monoclonal antibodies...
July 18, 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28718698/pegging-down-risk-factors-for-peg-asparaginase-hepatotoxicity-in-patients-with-acute-lymphoblastic-leukemia-%C3%A2
#4
Caitlin R Rausch, Bernard L Marini, Lydia L Benitez, Allison Elias, Patrick W Burke, Dale Bixby, Anthony J Perissinotti
Asparaginase is commonly de-emphasized/omitted in adult acute lymphoblastic leukemia regimens due to poor tolerability, including hepatotoxicity (HTX). Adult patients (n = 100) given induction therapy containing pegylated asparaginase (PEG) from January 2008 to February 2016 were evaluated for HTX. Sixteen patients met criteria for HTX (direct bilirubin >3 g/dL). A multivariable model identified body surface area >2m(2) (OR 7.40; 95% CI: 1.73-31.61, p = .007), albumin <3 mg/dL (OR 4.62; 95% CI: 1...
July 18, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28704720/the-dana-farber-consortium-protocol-dfcp-vs-classic-hyper-cvad-for-treatment-of-acute-lymphoblastic-leukemia-in-patients-50-y-single-institution-experience
#5
Amal S Alabdulwahab, Hussein G Elsayed, Mohamed A Sherisher, Ahmed Zeeneldin, Khalofa Alghamdi, Wafaa M Elbjeirami
BACKGROUND: The use of intensive pediatric protocols for the treatment of ALL is being extended to older adults. AIM OF THE STUDY: Analysis of the efficacy and toxicity results of pediatric DFCP vs. classic Hyper-CVAD protocol for the treatment of patients with ALL < 50 Y. PATIENTS AND METHODS: A retrospective single center comparative analysis of DFCP & classic Hyper-CVAD for first line treatment of patients with ALL < 50 Y. RESULTS: 73 patients were included, 43 received DFCP and 30 received Hyper-CVAD protocol...
June 28, 2017: Leukemia Research
https://www.readbyqxmd.com/read/28693363/prognostic-impact-of-incomplete-hematologic-count-recovery-and-minimal-residual-disease-on-outcome-in-adult-acute-lymphoblastic-leukemia-at-the-time-of-second-complete-response
#6
Caner Saygin, Nikolaos Papadantonakis, Ryan D Cassaday, Michaela Liedtke, Katrina Fischer, Tamara Dunn, Bhumika J Patel, Ronald Sobecks, Matt Kalaycio, Mikkael A Sekeres, Sudipto Mukherjee, Aaron T Gerds, Betty K Hamilton, Hetty E Carraway, Anjali S Advani
Outcomes of relapsed adult acute lymphoblastic leukemia (ALL) have improved over time with the introduction of new therapies as well as better supportive care. However, there is still a need for easy-to-use and accurate prognostic tools for patients in first relapse. Whether complete response (CR) with incomplete count recovery (CRh) can be grouped with CR in relapsed ALL trials has not been formally studied. We analyzed 106 ALL patients at first relapse who were treated at three academic centers and achieved CR/CRh...
July 11, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28689002/age-acts-as-an-adverse-independent-variable-for-survival-in-acute-lymphoblastic-leukemia-data-from-a-cohort-in-northeast-mexico
#7
José Carlos Jaime-Pérez, Lucía Teresa Fernández, Raúl Alberto Jiménez-Castillo, Andrés Gómez-De León, Olga Graciela Cantú-Rodríguez, César Homero Gutiérrez-Aguirre, David Gómez-Almaguer
BACKGROUND: Survival for acute lymphoblastic leukemia (ALL) decreases with age. Patients across all age groups from a homogeneous ethnic and socioeconomic background were studied to document age effect. MATERIAL AND METHODS: Patients diagnosed from 2005 to 2015 at a university hospital in Northeast Mexico were divided into 4 age groups: infants (< 1), children (≥ 1 to < 16), adolescents (≥ 16 to ≤ 20), and adults (> 20 years). Correlation between age at diagnosis and relapse-free (RFS) and overall survival (OS) was investigated...
June 17, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28679301/tp53-in-adult-acute-lymphoblastic-leukemia
#8
Silvia Salmoiraghi, Alessandro Rambaldi, Orietta Spinelli
Acute lymphoblastic leukemia (ALL) is characterized by a great biological and clinical heterogeneity. Despite most adult patients enter complete hematologic remission after induction therapy only 40% survive five or more years. Over the last 20 years, the definition of an accurate biologic leukemia profile and the minimal residual disease evaluation in addition to conventional risk criteria led to a significant improvement for the risk stratification. The alterations of the oncosuppressor gene TP53, including deletions, sequence mutations and defect in its expression due to regulatory defects, define a new important predictor of adverse outcome...
July 6, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28671688/the-genomic-landscape-of-pediatric-and-young-adult-t-lineage-acute-lymphoblastic-leukemia
#9
Yu Liu, John Easton, Ying Shao, Jamie Maciaszek, Zhaoming Wang, Mark R Wilkinson, Kelly McCastlain, Michael Edmonson, Stanley B Pounds, Lei Shi, Xin Zhou, Xiaotu Ma, Edgar Sioson, Yongjin Li, Michael Rusch, Pankaj Gupta, Deqing Pei, Cheng Cheng, Malcolm A Smith, Jaime Guidry Auvil, Daniela S Gerhard, Mary V Relling, Naomi J Winick, Andrew J Carroll, Nyla A Heerema, Elizabeth Raetz, Meenakshi Devidas, Cheryl L Willman, Richard C Harvey, William L Carroll, Kimberly P Dunsmore, Stuart S Winter, Brent L Wood, Brian P Sorrentino, James R Downing, Mignon L Loh, Stephen P Hunger, Jinghui Zhang, Charles G Mullighan
Genetic alterations that activate NOTCH1 signaling and T cell transcription factors, coupled with inactivation of the INK4/ARF tumor suppressors, are hallmarks of T-lineage acute lymphoblastic leukemia (T-ALL), but detailed genome-wide sequencing of large T-ALL cohorts has not been carried out. Using integrated genomic analysis of 264 T-ALL cases, we identified 106 putative driver genes, half of which had not previously been described in childhood T-ALL (for example, CCND3, CTCF, MYB, SMARCA4, ZFP36L2 and MYCN)...
July 3, 2017: Nature Genetics
https://www.readbyqxmd.com/read/28666906/craniospinal-irradiation-prior-to-stem-cell-transplant-for-hematologic-malignancies-with-cns-involvement-effectiveness-and-toxicity-after-photon-or-proton-treatment
#10
Jillian R Gunther, Ahmad R Rahman, Wenli Dong, Zeinab Abou Yehia, Partow Kebriaei, Gabriela Rondon, Chelsea C Pinnix, Sarah A Milgrom, Pamela K Allen, Bouthaina S Dabaja, Grace L Smith
PURPOSE/OBJECTIVE(S): Craniospinal irradiation (CSI) improves local control of leukemia/lymphoma with central nervous system (CNS) involvement; however, for adult patients anticipating stem cell transplant (SCT), cumulative treatment toxicity is a major concern. We evaluated toxicities and outcomes for patients receiving proton or photon CSI before SCT. METHODS AND MATERIALS: We identified 37 consecutive leukemia/lymphoma patients with CNS involvement who received CSI before SCT at our institution...
May 10, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28666090/emerging-role-of-immunotherapy-in-precursor-b-cell-acute-lymphoblastic-leukemia
#11
Gautam Kishore Valecha, Uroosa Ibrahim, Sassine Ghanem, Divya Asti, Jean-Paul Atallah, Terenig Terjanian
Acute lymphoblastic leukemia (ALL) is an aggressive type of leukemia that carries poor prognosis in adults especially in the setting of high risk cytogenetics and relapsed/refractory (R/R) disease. Advancements in immunotherapy have led to the development of several monoclonal antibodies (MoAbs) and chimeric antigen receptor (CAR) T cells that are capable of targeting certain surface antigens on leukemic cells, resulting in their destruction. Areas covered: This article reviews the mechanism of action, outcomes of various trials, and adverse effects of MoAbs and CAR-T cells used in the treatment of precursor B-cell ALL...
July 10, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28665419/acute-lymphoblastic-leukemia-a-comprehensive-review-and-2017-update
#12
REVIEW
T Terwilliger, M Abdul-Hay
Acute lymphoblastic leukemia (ALL) is the second most common acute leukemia in adults, with an incidence of over 6500 cases per year in the United States alone. The hallmark of ALL is chromosomal abnormalities and genetic alterations involved in differentiation and proliferation of lymphoid precursor cells. In adults, 75% of cases develop from precursors of the B-cell lineage, with the remainder of cases consisting of malignant T-cell precursors. Traditionally, risk stratification has been based on clinical factors such age, white blood cell count and response to chemotherapy; however, the identification of recurrent genetic alterations has helped refine individual prognosis and guide management...
June 30, 2017: Blood Cancer Journal
https://www.readbyqxmd.com/read/28657534/-mutations-in-the-bcr-abl1-gene-in-a-peruvian-patient-with-acute-lymphoblastic-leukemia-resistant-to-therapy
#13
Cesar A Ortiz, Yubell P Alvarez, Kenny L Dongo-Pflucker, Emilio Valdivia, Julio Mendoza Fernández, Silvia Dávila, Pamela Mora-Alférez
CONTEXT: The fusion gene BCR-ABL1 is present in at least the fourth part of B-cell acute lymphoblastic leukemia adult cases. Patients with this fusion gene are candidates to tyrosine kinase inhibitors treatment, and the response to this therapy can be measure by quantification of BCR-ABL1 transcripts. Some patients relapse because the presence of mutations in the tyrosine kinase domain of BCR-ABL1. CASE REPORT: This is a report of a patient with BCR-ABL1 who initially achieved molecular response with imatinib therapy, relapsing after fifteen months...
2017: Revista de la Facultad de Ciencias Médicas
https://www.readbyqxmd.com/read/28654205/driving-toward-precision-medicine-for-acute-leukemias-are-we-there-yet
#14
Clement Chung, Hilary Ma
Despite recent progress in the understanding of the molecular basis of acute leukemias, treatment options for these diseases have not shown significant changes over the last few decades. In this review, we present a nonexhaustive key summary of the current cytogenetic and molecular changes associated with acute leukemias in disease prognostication and potential targeted therapies. An emerging paradigm is that many genetic or molecular alterations target similar signal transduction, transcriptional, and epigenetic pathways...
June 27, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28654149/young-adult-survivors-of-childhood-acute-lymphoblastic-leukemia-show-evidence-of-chronic-inflammation-and-cellular-aging
#15
Hany Ariffin, Mohamad Shafiq Azanan, Sayyidatul Syahirah Abd Ghafar, Lixian Oh, Kee Hie Lau, Tharshanadhevasheri Thirunavakarasu, Atiqah Sedan, Kamariah Ibrahim, Adelyne Chan, Tong Foh Chin, Fong Fong Liew, Shareni Jeyamogan, Erda Syerena Rosli, Rashidah Baharudin, Tsiao Yi Yap, Roderick Skinner, Su Han Lum, Pierre Hainaut
BACKGROUND: Large epidemiologic studies have reported the premature onset of age-related conditions, such as ischemic heart disease and diabetes mellitus, in childhood cancer survivors, decades earlier than in their peers. The authors investigated whether young adult survivors of childhood acute lymphoblastic leukemia (ALL) have a biologic phenotype of cellular ageing and chronic inflammation. METHODS: Plasma inflammatory cytokines were measured using a cytometric bead array in 87 asymptomatic young adult survivors of childhood ALL (median age, 25 years; age range, 18-35 years) who attended annual follow-up clinic and compared with healthy, age-matched and sex-matched controls...
June 27, 2017: Cancer
https://www.readbyqxmd.com/read/28649984/cd27-expression-and-its-association-with-clinical-outcome-in-children-and-adults-with-pro-b-acute-lymphoblastic-leukemia
#16
D Chen, N Gerasimčik, A Camponeschi, Y Tan, Q Wu, S Brynjolfsson, J Zheng, J Abrahamsson, J Nordlund, G Lönnerholm, L Fogelstrand, I-L Mårtensson
No abstract text is available yet for this article.
June 23, 2017: Blood Cancer Journal
https://www.readbyqxmd.com/read/28644949/hematopoietic-cell-transplantation-for-acute-lymphoblastic-leukemia-in-adult-patients
#17
REVIEW
Riad El Fakih, Syed Ahmed, Feras Alfraih, Amr Hanbali
Acute lymphoblastic leukemia (ALL) consists of precursor B ALL or T ALL phenotypes. In the pediatric population, ALL patients enjoy an 80% long-term survival with the current pediatric chemotherapy protocols as compared with 50% long-term survival in the adult population. In adults, complete remission rates are similar to those of pediatric patients; however, long-term survival is much lower with the majority of deaths attributable to relapsed disease. Postremission consolidation strategies in adults include chemotherapy, autologous, or allogeneic transplant...
June 15, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28644144/meta-analysis-of-the-clinical-characteristics-and-prognostic-relevance-of-notch1-and-fbxw7-mutation-in-t-cell-acute-lymphoblastic-leukemia
#18
Rong-Bin Liu, Jian-Gui Guo, Tian-Ze Liu, Cheng-Cheng Guo, Xin-Xiang Fan, Xiao Zhang, Xiu-Yu Cai, Wei-Han Hu
The NOTCH1 signaling pathway is crucial for T-cell development, and NOTCH1 and/or FBXW7 mutations are frequently detected in T-cell acute lymphoblastic leukemia (T-ALL). We performed a systematic review and meta-analysis of 18 randomized controlled trials (RCTs) to assess the prognostic impact of mutations in the NOTCH1 pathway. After retrieving relevant articles from PubMed, EMBASE, and the Cochrane Library, we investigated overall survival (OS) and event-free survival (EFS) with hazard ratios (HRs) using fixed-effects or random-effects models and conducted subgroup analyses based on population and mutation status...
June 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28641623/-analysis-of-clinical-characteristics-and-therapeutic-efficacy-in-61-adult-patients-with-acute-lymphoblastic-leukemia
#19
Xiao-Ping Zhang, Bao-An Chen, Zheng Ge, Ran Liu, Xiao-Yan Ma, Chong Gao
OBJECTIVE: To investigate the clinical characteristics and curative effect in 61 adult patients with acute lymphoblastic leukemia (ALL). METHODS: The clinical data of 61 patients (≥15 years old) with ALL enrolled from January 2010 to December 2014 were studied retrospectively. The relationship between clinical characteristics and curative effect was analyzed. The univariate and multivariate analyses related with the overall survival (OS) and disease free survival (DFS) were conducted by using the method of COX regression analysis...
June 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/28637512/single-or-double-unit-ucbt-following-ric-in-adults-with-al-a-report-from-eurocord-the-alwp-and-the-ctiwp-of-the-ebmt
#20
Frédéric Baron, Annalisa Ruggeri, Eric Beohou, Myriam Labopin, Mohamad Mohty, Didier Blaise, Jan J Cornelissen, Patrice Chevallier, Guillermo Sanz, Eefke Petersen, Bipin N Savani, Eliane Gluckman, Arnon Nagler
BACKGROUND: The feasibility of cord blood transplantation (CBT) in adults is limited by the relatively low number of hematopoietic stem/progenitor cells contained in one single CB unit. The infusion of two CB units from different partially HLA-matched donors (double CBT) is frequently performed in patients who lack a sufficiently rich single CB unit. METHODS: We compared CBT outcomes in patients given single or double CBT following reduced-intensity conditioning (RIC) in a retrospective multicenter registry-based study...
June 21, 2017: Journal of Hematology & Oncology
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