1,721,661 research outputs found
Acute lymphoblastic leukemia: age and biology.
No full textAcute lymphoblastic leukemia (ALL) is the most frequent neoplasm in children, while being relatively rare in adults. The outcome of children with ALL is far superior than that observed in adults, whose survival rates generally do not exceed 40%. A retrospective analysis recently carried out on a large series of cases enrolled in the AIEOP and GIMEMA protocols for the treatment of pediatric and adult ALL has documented specific differences among the various age cohorts examined, particularly in terms of incidence of molecular rearrangements, with the BCR/ABL rearrangement being detected in more than half of patients in the 6(th) decade of life. These findings highlight the importance of a precise diagnostic screening at all ages, since elderly patients might benefit more from targeted approaches, that are associated with less toxic effects. Furthermore, extended biologic approaches aimed at identifying novel therapeutic targets should be regarded as a main goal to refine our therapeutic armamentarium.Finally, the introduction of pediatric-like protocols is progressively changing the outcome of young adult patients, although an important caveat is represented by the comorbidities and toxic effects associated with more aggressive chemotherapy; therefore, patients' fitness should always be carefully considered
The European Hematology Association: strengthening hematology in Europe and beyond
No full textEuropean hematology is increasingly recognized as a medical speciality that contributes to public health through the development of new therapies for the management of malignant and nonmalignant blood diseases. The European Hematology Association (EHA) is a nonprofit scientific association that represents European medical professionals with an active interest in hematology. Our aim is to promote excellence in clinical practice, research and education in European hematology. An executive board and councillors elected by the members form the governmental body of EHA and are responsible for the strategy and organization of the association. Various EHA committees and units are assigned to the activities and programs of the EHA. The EHA has an important role to play by making education and training easily accessible in Europe and further afield. In order to best serve the European hematologist, the association has developed scientific programs and activities in a variety of areas. Besides focusing on European hematology, the EHA has also dedicated itself to outreach programs; an initiative to complement the needs of hematology education and to emphasize important topics of benefit to hematologists, not only in Europe, but also in other regions
Management of adult Ph-positive acute lymphoblastic leukemia
No full textPhiladelphia-positive acute lymphoblastic leukemia (Ph+ ALL) has been regarded for decades as the ALL subgroup with the worse outcome. It represents the most frequent genetic subtype of adult ALL, and increases progressively with age. The introduction of tyrosine kinase inhibitors (TKIs) has enabled to obtain complete hematologic remissions (CHRs) in virtually all patients, including the elderly, to improve disease-free survival and overall survival, as well as to increase the percentage of patients who can undergo an allogeneic stem cell transplant (allo-SCT).The current management of adult Ph+ ALL patients relies on the use of a TKI with or without chemotherapy followed by an allo-SCT, which still remains the only curative option. Minimal residual disease screening is permitting not only a better stratification of patients, but has also allowed to reconsider the role of autologous stem cell transplant for a set of patients who do not have a donor or are not eligible for an allo-SCT. At present, clinical challenges are represented by the emergence of resistant mutations, particularly the gatekeeper T315I, for which alternative approaches, comprising novel TKIs or therapies based on the combination of TKI with immunotherapeutic strategies, are being considered in order to overcome resistance
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