Recurrent acute lymphoblastic leukaemia(ALL) is a common disease for pediatric oncologists and accounts for more deaths from cancer in children than any other malignancy. Although most patients achieve a second remiss...Recurrent acute lymphoblastic leukaemia(ALL) is a common disease for pediatric oncologists and accounts for more deaths from cancer in children than any other malignancy. Although most patients achieve a second remission, about 50% of relapsed ALL patients do not respond to salvage therapy or suffer a second relapse and most children with relapse die. Treatment must be tailored after relapse of ALL, since outcome will be influenced by well-established prognostic features, including the timing and site of disease recurrence, the disease immunophenotype, and early response to retrieval therapy in terms of minimal residual disease(MRD). After reinduction chemotherapy, high risk(HR) patients are clear candidates for allogeneic stem cell transplantation(SCT) while standard risk patients do better with conventional chemotherapy and local therapy. Early MRD response assessment is currently applied to identify those patients within the more heterogeneous intermediate risk group who should undergo SCT as consolidation therapy. Recent evidence suggests distinct biological mechanisms for early vs late relapse and the recognition of the involvement of certain treatment resistance related genes as well cell cycle regulation and B-cell development genes at relapse, all providing the opportunity to search for novel target therapies.展开更多
Background:Anti-neutrophil antibodies are a wellrecognized cause of neutropenia,producing a potential increase in risk of infection:in the majority of patients antibodies react against antigens located on the IgG Fc r...Background:Anti-neutrophil antibodies are a wellrecognized cause of neutropenia,producing a potential increase in risk of infection:in the majority of patients antibodies react against antigens located on the IgG Fc receptor type 3b(FcRIIIb),but other target antigens have been identified.Data sources:In this review the most important papers of auto and alloimmune neutropenias of infancy and childhood were analyzed.PubMed,Google Scholar and Thompson ISI Web of Knowledge were searched for identifying relevant papers.Results:Primary autoimmune neutropenia of infancy is mostly a benign condition with self-limited course,whereas isolated alloimmune neonatal neutropenia or secondary autoimmune neutropenia may be occasionally complicated by severe infections.Conclusion:Granulocyte colony stimulating factor is an effective therapy for patients affected by all types of autoimmune and alloimmune neutropenia,even though most of them do not need any therapy.展开更多
文摘Recurrent acute lymphoblastic leukaemia(ALL) is a common disease for pediatric oncologists and accounts for more deaths from cancer in children than any other malignancy. Although most patients achieve a second remission, about 50% of relapsed ALL patients do not respond to salvage therapy or suffer a second relapse and most children with relapse die. Treatment must be tailored after relapse of ALL, since outcome will be influenced by well-established prognostic features, including the timing and site of disease recurrence, the disease immunophenotype, and early response to retrieval therapy in terms of minimal residual disease(MRD). After reinduction chemotherapy, high risk(HR) patients are clear candidates for allogeneic stem cell transplantation(SCT) while standard risk patients do better with conventional chemotherapy and local therapy. Early MRD response assessment is currently applied to identify those patients within the more heterogeneous intermediate risk group who should undergo SCT as consolidation therapy. Recent evidence suggests distinct biological mechanisms for early vs late relapse and the recognition of the involvement of certain treatment resistance related genes as well cell cycle regulation and B-cell development genes at relapse, all providing the opportunity to search for novel target therapies.
文摘Background:Anti-neutrophil antibodies are a wellrecognized cause of neutropenia,producing a potential increase in risk of infection:in the majority of patients antibodies react against antigens located on the IgG Fc receptor type 3b(FcRIIIb),but other target antigens have been identified.Data sources:In this review the most important papers of auto and alloimmune neutropenias of infancy and childhood were analyzed.PubMed,Google Scholar and Thompson ISI Web of Knowledge were searched for identifying relevant papers.Results:Primary autoimmune neutropenia of infancy is mostly a benign condition with self-limited course,whereas isolated alloimmune neonatal neutropenia or secondary autoimmune neutropenia may be occasionally complicated by severe infections.Conclusion:Granulocyte colony stimulating factor is an effective therapy for patients affected by all types of autoimmune and alloimmune neutropenia,even though most of them do not need any therapy.
