Miguel Bronchud: An Unfinished Success Story…
Miguel Bronchud, Co-Founder & Advisory Board at Regenerative Medicine Solutions, shared on LinkedIn:
“Acute lymphocytic leukemia? An unfinished success story…
From certain death fifty odd years ago, to over three consecutive years of chemotherapy and radiotherapy- including prophylactic CNS irradiation- and (if lucky) allogeneic stem-cell transplantation…
to current successful chemo immune therapies (including targeted oral therapies) and CAR-T?
Acute lymphocytic leukaemia (ALL) is a haematological malignancy of the lymphoid progenitor cells: both B-cell and T-cells.
Enhanced genetic analyses have led to the identification of over 23 subtypes of B-cell and 17 subtypes of T-cell ALL.
Brady, SW ∙ Roberts, KG ∙ Gu, Z ∙ et al.
Title: The genomic landscape of pediatric acute lymphoblastic leukemia
Authors: Samuel W Brady, Kathryn G Roberts, Zhaohui Gu, Lei Shi, Stanley Pounds, Deqing Pei, Cheng Cheng, Yunfeng Dai, Meenakshi Devidas, Chunxu Qu, Ashley N Hill, Debbie Payne-Turner, Xiaotu Ma, Ilaria Iacobucci, Pradyuamna Baviskar, Lei Wei, Sasi Arunachalam, Kohei Hagiwara, Yanling Liu, Diane A Flasch, Yu Liu, Matthew Parker, Xiaolong Chen, Abdelrahman H Elsayed, Omkar Pathak, Yongjin Li, Yiping Fan, J Robert Michael, Michael Rusch, Mark R Wilkinson, Scott Foy, Dale J Hedges, Scott Newman, Xin Zhou, Jian Wang, Colleen Reilly, Edgar Sioson, Stephen V Rice, Victor Pastor Loyola, Gang Wu, Evadnie Rampersaud, Shalini C Reshmi, Julie Gastier-Foster, Jaime M Guidry Auvil, Patee Gesuwan, Malcolm A Smith, Naomi Winick, Andrew J Carroll, Nyla A Heerema, Richard C Harvey, Cheryl L Willman, Eric Larsen, Elizabeth A Raetz, Michael J Borowitz, Brent L Wood, William L Carroll, Patrick A Zweidler-McKay, Karen R Rabin, Leonard A Mattano, Kelly W Maloney, Stuart S Winter, Michael J Burke, Wanda Salzer, Kimberly P Dunsmore, Anne L Angiolillo, Kristine R Crews, James R Downing, Sima Jeha, Ching-Hon Pui, William E Evans, Jun J Yang, Mary V Relling, Daniela S Gerhard, Mignon L Loh, Stephen P Hunger, Jinghui Zhang, Charles G Mullighan
Nat Genet. 2022; 54:1376-1389
In parallel, the development of highly sensitive measurable residual disease assays have refined disease monitoring and risk stratification.
Breakthroughs in molecular therapeutics and immunotherapies have improved treatment efficacy while reducing toxicity, challenging the traditional notion of 2·5–3 years of intensive chemotherapy.
See: ‘The evolution of acute lymphoblastic leukemia research and therapy at MD Anderson over four decades’ was nicely reviewed by Elias Jabbour et al. J Hematol Oncol. 2023.
Authors: Elias Jabbour, Nicholas J. Short, Nitin Jain, Fadi G. Haddad, Mary Alma Welch, Farhad Ravandi & Hagop Kantarjian
Notable progress includes the use of more potent BCR::ABL1 tyrosine-kinase inhibitors,
Authors: Robin Foà, Renato Bassan, Loredana Elia, Alfonso Piciocchi, Stefano Soddu, Monica Messina, Felicetto Ferrara, Monia Lunghi, Antonino Mulè, Massimiliano Bonifacio, Nicola Fracchiolla, Prassede Salutari, Paola Fazi, Anna Guarini, Alessandro Rambaldi, Sabina Chiaretti
and antibodies targeting CD19 and CD22 leukaemia surface antigens, which have delivered unprecedented outcomes in BCR::ABL1-positive ALL.
Title: Treatment of Adults With Philadelphia Chromosome–Positive Acute Lymphoblastic Leukemia—From Intensive Chemotherapy Combinations to Chemotherapy-Free Regimens
Authors: Elias Jabbour, Fadi G. Haddad, Nicholas J. Short, Hagop Kantarjian
Historically, adults have had poorer outcomes than paediatric cases, largely due to the higher prevalence of adverse genetic subtypes and less favourable genetic subtypes.
An anecdotal example was the great Catalan tenor Josep Carreras , one of the fabulous Three Tenors
Carreras, in the late 1980s, developed this dreadful disease ALL and was initially treated at Hospital Clinic of Barcelona (by Prof C.Rozman & Albert Grañena) but was flown to Seattle under the care of Nobel winner Prof. Thomas . {E. Donnall Thomas (1920-2012)}.
After a bone marrow transplant, the famous Barcelona singer had difficulties recovering his peripheral blood count and (shortly after a personal, almost “farewell visit, by his great friend and colleague Luciano Pavarotti ) he was rescued by GM-CSF …
Edward Donnall Thomas, known as ‘Don’ to his friends, was born in a small town in central Texas in 1920. His most notable achievement, the Nobel Prize in Medicine, was awarded in 1990 for his development of bone marrow transplantation, which could cure patients with advanced leukemia.
However, more recent development of new therapies has improved overall survival in B-cell ALL to approximately 80–90%, even in adult and infant populations.”
More posts featuring Miguel Bronchud.
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Challenging the Status Quo in Colorectal Cancer 2024
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ESMO 2024 Congress
September 13-17, 2024
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ASCO Annual Meeting
May 30 - June 4, 2024
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Yvonne Award 2024
May 31, 2024
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OncoThon 2024, Online
Feb. 15, 2024
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Global Summit on War & Cancer 2023, Online
Dec. 14-16, 2023