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Acute lymphoblastic leukemia (ALL) is a malignant condition of lymphoid progenitor cells that primarily affects the pediatric population, but also adults. The 5-year survival rate is 90% in children and approximately 40% in adults, with survival increasing through the use of peripheral stem cell allotransplantation (SCT). The relapse rate after stem cell transplantation (SCT) in adult acute lymphoblastic leukemia (ALL) patients ranges from 35% to 45%, making relapse a major cause of death in this population.
View Article and Find Full Text PDFMacroscopic Hematuria Revealing Bladder Myeloid Sarcoma in Acute Myeloid Leukemia.
Cureus
December 2024
Department of Hematology, Hôpital Universitaire de Bruxelles (HUB) Institut Jules Bordet, Brussels, BEL.
Acute myeloid leukemia (AML) can be presented with extramedullary manifestations, more frequently involving skin and rarely other sites, such as the urinary tract. We report the case of a 37-year-old male patient with a history of testicular cancer who presented to the emergency department with cytopenias and hematuria. Bone marrow analysis diagnosed AML (French-American-British(FAB) classificationM4 subtype, karyotype showing inv16).
View Article and Find Full Text PDFTP53 Mutations are Associated with CD19 Negative Relapse and Inferior Outcomes after Blinatumomab in Adults with ALL.
Blood Adv
January 2025
City of Hope Medical Center, Duarte, California, United States.
Despite the success of the CD19xCD3 T cell engager blinatumomab in B-cell acute lymphoblastic leukemia (B-ALL), treatment failure is common and can manifest with antigen loss and extramedullary disease (EMD) relapse. To understand the impact of leukemia genetics on outcomes, we reviewed 267 adult patients with B-ALL treated with blinatumomab and used next generation sequencing to identify molecular alterations. Patients received blinatumomab for relapsed/refractory (R/R) disease (n=150), minimal residual disease (MRD+) (n=88), upfront as induction (n=10), or as consolidation in MRD- state (n=19).
View Article and Find Full Text PDFCD19-directed chimeric antigen receptor-engineered (CD19 CAR) T-cell therapy elicits high response rates but fails to induce durable responses in most adults with relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL). In a previous clinical trial (NCT01865617), we observed anti-CAR immune responses associated with impaired in vivo CAR T-cell expansion after second infusions. Because these CD8+ T-cell responses were predominantly directed at peptides derived from the murine single chain variable fragment (scFv) in the CAR, we conducted a clinical trial investigating the safety and efficacy of CD19 CAR T-cells engineered with a CAR incorporating a fully human scFv (JCAR021) in adults with R/R B-ALL (NCT03103971).
View Article and Find Full Text PDFInducing apoptosis in acute myeloid leukemia; mechanisms and limitations.
Heliyon
January 2025
Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Acute myeloid leukemia is the expansion of leukemic stem cells which might originate from a stem cell or a progenitor which has acquired self-renewal capacity. An aggregation of leukemic blasts in bone marrow, peripheral blood, and extramedullary tissue will result in acute myeloid leukemia. The main difficulty in treating acute myeloid leukemia is multidrug resistance, leading to treatment failure.
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