2 de desembre de 2015

The Stem cells, Mesenchymal cancer and development group publish a new review of Infant t(4;11)/MLL-AF4+ B-cell acute lymphoblastic leukemia

In this paper led by Dr Alejandra Sanjuan-Pla the authors give a comprehensive description of what is known about this distressing leukemia of newborn babies

A review paper is a description of all the current knowledge and research results for a particular illness or scientific question. These papers are extremely valuable for other researchers, they are widely read and are often cited in other publications.

Of childhood acute lymphoblastic leukemias, the infant B-cell type (B-ALL) accounts for about 10%.  Most cases of B-ALL have rearrangements on the mixed-lineage leukemia gene, which is called MLL. Although 85-90% of children diagnosed with B-ALL survive after treatment, due to improvements in care, personalized therapy and support, children diagnosed as babies do very badly, with fewer than 35% surviving to grow up.  In these cases the disease does not remain hidden long but suddenly becomes extremely aggressive with immature blood cells multiplying uncontrollably. The disease is highly distressing as tiny babies suddenly become ill and die.

Because it occurs in such vulnerable patients and progresses so fast, it is not possible to study this type of infant B-ALL in actual patient samples.  One of the missions of scientists in this field, and of the Stem cells, Mesenchymal cancer and development group in particular, isto create cells in the laboratory that behave in the same way as cells in the leukemia process. This is especially difficult, as the cells involved seem to become cancerous before birth, which means that this leukemia is not simply a case of blood cells multiplying incorrectly but a problem of the early development of the fetus in the first place. This makes it a different disease from adult or even other childhood B-ALLs.

Dr Sanjuan-Pla describes different types of this sub-group of B-ALL; their medical characteristics, the precise molecular changes involved and the causes and progression of the disease. Although it is generally agreed that for a cancer to develop several steps must occur before a tumour appears, she discusses the argument that in this case it may only require one step to trigger it.  Some researchers suggest that it can be traced back to a leukemia-initiating cell that appears before the baby is born.

Finally, the review describes work currently being carried out and how new technological techniques could considerably increase our knowledge of what is happening in order to be able to successfully treat this heart-breaking disease.

Link to paper on PubMed: http://1.usa.gov/1NqmzaO