Treatment of Acute Leukemias: New Directions for Clinical by Ching-Hon Pui

By Ching-Hon Pui

Foreign specialists not just assessment the cutting-edge in dealing with kids and adults with acute leukemia, but in addition debate the professionals and cons of present debatable and complex concerns. The ebook summarizes the easiest diagnostic and therapy practices for acute leukemias in childrens, youngsters, and adults. one of the treatments mentioned are methotrexate, asparaginase, antipurines, epipodophyllotoxins, hematopoietic stem cellphone transplantation, hematopoietic development components, and immunotherapy.

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Sample text

The crucial event in all three translocations is the juxtaposition of the oncogene MYC, located on 8q24, with either the immunglobulin heavychain locus (14q32), the immunglobulin light-chain locus g (2p12), or the immunglobulin light-chain locus l (22q11). Under the influence of transcription-stimulating sequences in the constitutively active immunglobulin locus, the transcription of MYC is increased, ultimately leading to neoplastic growth. t(8;14) is the most common (85%) of these rearrangements, whereas t(2;8) and t(8;22) are found in around 5 and 10% of patients, respectively (35).

Molecular techniques have defined a minimal deleted region, but so far the putative tumor suppressor gene on the long arm of chromosome 6 has not been cloned (376). Clinical studies have either confirmed no difference in prognosis or reported improved outcomes for 6q deletions (267,354). 13. 9p Abnormalities Loss of 9p material can occur owing to deletions or unbalanced translocations. The commonly deleted region was found to be 9p21-p22. From 7 to 12% of childhood and 12 to 15% of adult ALL cases show 9p abnormalities (267,347,360).

Both mechanisms lead to a transcriptional activation of TAL1. Outcome seems not to differ significantly between patients with or without TAL1 rearrangement (281). Despite the proven diagnostic and prognostic value of cytogenetic analyses in ALL, there are compelling reasons to add molecular techniques.

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