Publications by authors named "Carol Fries"
Detailed characterization of the B-lymphoblastic leukemia (B-ALL) cells which invade the central nervous system (CNS) has been limited by practical challenges. To test whether the clonal composition of the cerebrospinal fluid (CSF) reflects the primary B-ALL tissue, we applied immunoglobulin (Ig) high-throughput sequencing (HTS) of archival CSF cytospin preparations from six patients with morphologically defined CNS involvement. We discovered that most CSF clones are detectable at some timepoint in the primary tissue, but that shifting clonal abundance is prevalent across tissue sites between diagnosis and relapse.
View Article and Find Full Text PDFThere are limited data pertaining to the prognostic features and optimal therapeutic approach for the 20%-25% of children with lymphoblastic lymphoma (LLy) who have the B-lymphoblastic subtype. Outcomes are favorable following treatment modeled after acute lymphoblastic leukemia (ALL) regimens, but prognosis is dismal after relapse, and there are no established features for predicting therapy response. Ongoing US and international trials will include the largest cohort of uniformly treated patients with B-LLy to date, providing an opportunity to define clinical and molecular predictors of relapse and to establish a standard of care for treatment to improve outcomes for this rare pediatric cancer.
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- A 13-year-old patient with T-LGL leukemia did not respond to standard treatments and eventually received a bone marrow transplant (BMT).
- Three years after the BMT, the patient is stable and in remission, suggesting that BMT could be an effective cure for resistant cases in very young individuals.
Malignant central nervous system (CNS) tumors in young children have a poor prognosis and pose a therapeutic challenge. We describe 11 patients with high-risk CNS tumors (6 atypical teratoid/rhabdoid tumor, 4 nonmedulloblastoma CNS embryonal tumors, and 1 glioblastoma multiforme) who received 32 consolidation cycles of myeloablative carboplatin/thiotepa followed by autologous peripheral blood stem cell rescue. All patients underwent successful stem cell harvest without significant complications.
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- Infant acute myeloid leukemia is a rare and aggressive cancer found in young children, where two specific cases showed high white blood cell counts (hyperleukocytosis) and later isolated relapses in the central nervous system during chemotherapy.
- Both infants successfully received bone marrow transplants with a specific regimen that did not involve radiation, and they underwent a series of lumbar punctures with an anticancer drug.
- The treatment was well-tolerated with no major complications, suggesting that this method could be a viable option for treating high-risk infants with leukemia.
Article Synopsis
- Acute lymphoblastic leukemia (ALL) consists of various subclones, and researchers investigated if blood clonal composition reflects that of the bone marrow at the onset of the disease.
- Using ultra-deep IGH sequencing, they identified a total of 28 genetic clones in 16 patients, with 5 clones present only in the bone marrow.
- The study revealed that sometimes the most common clones in the bone marrow were not the same as those found in the blood, indicating that blood samples may miss important minor subclones present in the bone marrow.
B cell acute lymphoblastic leukemia (B ALL) is a genetically heterogeneous neoplasm often demonstrating extensive subclone diversity within each patient's disease. The immunoglobulin heavy chain (IGH) locus is a marker of clonal variation in B ALL due to its intrinsic role in B lymphocyte development and its diverse Vh(D)Jh rearrangement patterns. B ALL IGH evolution may contribute to limitations in minimal residual disease (MRD) monitoring methods.
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