Publication: Leucemia linfoblástica aguda: infiltración en el sistema nervioso central y papel de BMP4
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2020-01-13
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Universidad Complutense de Madrid
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Abstract
La leucemia linfoblástica aguda (LLA) es la neoplasia más frecuente en la población infantil. Caracterizada por la alteración genética de las células hematopoyéticas que modifican su capacidad de proliferación y diferenciación, esta enfermedad se presenta con la acumulación de células tumorales en la médula ósea y la extensión extramedular de las mismas. La mejora de las estrategias terapéuticas, fundamentalmente debida a la estratificación de los pacientes en grupos de riesgo y al tratamiento profiláctico dirigido al sistema nervioso central (SNC), ha permitido que las tasas de supervivencia superen el 80% en la actualidad 1, 2. De esta forma, sólo los pacientes incluidos en el grupo de riesgo alto reciben tratamientos más intensivos, reduciéndose así los efectos secundarios derivados de la terapia 3. Por otra parte, la eficacia de la profilaxis en SNC pone de manifiesto que éste ya está colonizado en el momento del diagnóstico, a pesar de no detectarse la presencia de células tumorales en el líquido cefalorraquídeo (LCR) 4 con las técnicas de diagnóstico utilizadas...
Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. It is thought to originate from genetic alterations that disrupt lymphoid differentiation and proliferation ability in hematopoietic cells. This disease is defined by an accumulation of tumour cells in the bone marrow and the later extramedullar expansion. Improved treatment strategies, mainly due to patients stratification into risk adapted groups and prophylactic central nervous system (CNS) directed therapy, has led to an increase of survival rates to more than 80% 1, 2. Therefore, only those children included in high-risk group receive the most intensive treatments, thus reducing treatment-related adverse side-effects 3. On the other hand, the efficacy of CNS prophylaxis shows that CNS is already colonized by leukemic cells at diagnosis, even if presence of tumour cells in cerebrospinal fluid (CSF) is undetectable by using current diagnostic methods 4. In fact, studies from autopsies of children who died from ALL performed by Price et al. revealed that around 50-60% of patients had CNS involvement...
Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy. It is thought to originate from genetic alterations that disrupt lymphoid differentiation and proliferation ability in hematopoietic cells. This disease is defined by an accumulation of tumour cells in the bone marrow and the later extramedullar expansion. Improved treatment strategies, mainly due to patients stratification into risk adapted groups and prophylactic central nervous system (CNS) directed therapy, has led to an increase of survival rates to more than 80% 1, 2. Therefore, only those children included in high-risk group receive the most intensive treatments, thus reducing treatment-related adverse side-effects 3. On the other hand, the efficacy of CNS prophylaxis shows that CNS is already colonized by leukemic cells at diagnosis, even if presence of tumour cells in cerebrospinal fluid (CSF) is undetectable by using current diagnostic methods 4. In fact, studies from autopsies of children who died from ALL performed by Price et al. revealed that around 50-60% of patients had CNS involvement...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Biología Celular, leída el 19-11-2019