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188 4 a U G U S T 2 0 1 1 I V O L U M E 1 1 8 , N U M B E R 5 Blood
| Content Provider | Semantic Scholar |
|---|---|
| Author | Av, Rubtsova K. Rubtsov Lococo, Francesco |
| Abstract | memory B cells are an obligate developmental intermediate. Finally, it needs to be determined whether ABCs play essential roles in protective responses and/or in the pathogenesis of autoimmunity. MP. A B-cell subset uniquely responsive to innate stimuli accumulates in aged mice. accumulation of a novel CD11cϩ B-cell population is important for the development of autoimmunity. Park et al report in this issue of Blood that, despite the results reported in major clinical trials, the rate of early death (ED) in acute promyelocytic leukemia (APL) found in a population-based study remains high over the past 15 years. 1 B ased on data obtained from the US Surveillance , Epidemiology, and End Results (SEER) registry, the authors show that the ED rate for APL is not only considerably higher than that described in clinical trials (ie, 17% vs 3%–10%), 1,2 and that it has not been affected significantly by the advent of modern treatment with all-trans retinoic acid (ATRA). Given the rarity of APL (0.2-0.3 cases/ 100 000/year) the total number of cases represents a meager figure. However, because of the reasons detailed below, the issues raised by this article are relevant for hematologists, on-cologists, and health care providers in general. First of all, we are dealing with a highly curable malignancy. Once regarded as the most aggressive and rapidly fatal human leu-kemia, APL has become over the past 2 decades the most frequently curable leukemia, with more than 80% of patients now being long-term survivors after combinatorial regi-mens including ATRA and anthracycline-based chemotherapy. 2,3 However, it is extremely important that patients are managed in highly specialized and experienced units. 4 Early death, mainly because of hemorrhage , and disease relapse account for most failures currently reported in clinical trials. 2,4 Given the above-mentioned therapeutic achievements, ED presently represents, together with disease relapse, the major obstacle to further increasing the cure rate of APL patients. In fact, the impressive progress with antileukemic therapy to decrease the relapse rate has not been paralleled by similar advances in reducing ED. This report by Park et al is therefore very appropriate and timely. In terms of ED reporting, it may be that clinical trials only describe the tip of the iceberg. It is unclear at present what percentage of patients diagnosed with APL are in fact referred to specialized care. Unfortunately, this information is not available in the study by Park et al. Together with … |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://www.bloodjournal.org/content/bloodjournal/118/5/1188.full.pdf?sso-checked=true |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
