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Correspondence
BRAF Inhibition in Refractory Hairy-Cell Leukemia
To the Editor: Hairy-cell leukemia (HCL) is a mature B-cell lymphoid cancer that is commonly treated with purine analogues. Virtually all patients with HCL carry the BRAF V600E mutation, which constitutively activates the MEK–ERK pathway and which can be inhibited in vitro by the mutation…
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Clinical Therapeutics
Anti-CD20 Antibody Therapy for B-Cell Lymphomas
Foreword. This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this therapy, and potential adverse effects are…
Original Article
Somatic STAT3 Mutations in Large Granular Lymphocytic Leukemia
T-cell large granular lymphocytic leukemia was initially described as a clonal disorder of large granular lymphocytes involving blood, bone marrow, spleen, and liver. This disorder is characterized by the presence of abnormal CD3+CD8+CD57+ lymphocytes corresponding to activated effector cytotoxic T…
Editorial
Attacking Remaining Challenges in Childhood Leukemia
Approximately 80% of children with acute lymphoblastic leukemia (ALL) are now cured, with estimates that contemporary treatment may further increase the cure rate to near 90%. Yet this figure is deceptive; for those children with unfavorable features, defined either by disease biology or by…
Original Article
Outcomes after Induction Failure in Childhood Acute Lymphoblastic Leukemia
Current treatment for acute lymphoblastic leukemia (ALL) can effect a cure in approximately 80% of children with the disease.– The leading cause of treatment failure is relapse, for which a number of risk factors have been identified, with inadequate therapy being one of the most important.– A…
Editorial
Profiles in Leukemia
For years, scientists have postulated the evolution of a cancer as a series of acquired mutations and epigenetic alterations that accumulate in a progressive way, beginning with a single transformed cell. Within this process, subclones of cells develop that acquire new properties, giving cells…
Original Article
Prognostic Relevance of Integrated Genetic Profiling in Acute Myeloid Leukemia
Previous studies have highlighted the clinical and biologic heterogeneity of acute myeloid leukemia (AML).– However, a relatively small number of cytogenetic and molecular lesions have sufficient relevance to influence clinical practice. The prognostic relevance of cytogenetic abnormalities has…
Original Article
Clonal Architecture of Secondary Acute Myeloid Leukemia
The myelodysplastic syndromes, a heterogeneous group of diseases characterized by ineffective hematopoiesis, are the most common cause of acquired bone marrow failure in adults. Secondary acute myeloid leukemia (AML) develops in approximately one third of persons with myelodysplastic syndromes.…
Clinical Implications of Basic Research
The Histone Code and Treatments for Acute Myeloid Leukemia
Occasionally, two research disciplines converge at precisely the right moment and propel each other forward. Such is the case with a screen for growth regulators in acute myeloid leukemia and a small molecule synthesized to disrupt protein recognition of the histone code, recently reported by Zuber…
Original Article
ABVD Alone versus Radiation-Based Therapy in Limited-Stage Hodgkin's Lymphoma
Twenty years ago, the standard strategy in the case of patients with stage IA or IIA nonbulky Hodgkin's lymphoma included staging by means of laparotomy and subtotal nodal radiation therapy. With this treatment, 70 to 80% of patients were cured, but they remained at risk for premature death from…
- CME
Editorial
Chemotherapy Alone for Early-Stage Hodgkin's Lymphoma
Extensive radiation therapy was the first therapeutic advance in the treatment of early-stage Hodgkin's lymphoma. More recently, less extensive radiation therapy in combination with chemotherapy has resulted in the lowest reported rates of early relapse. The HD10 trial (ClinicalTrials.gov number,…
Correspondence
TET2 and DNMT3A Mutations in Human T-Cell Lymphoma
To the Editor: Despite the poor prognosis of T-cell lymphomas, the genetic basis of these cancers is poorly defined. We have found acquired TET2 mutations in both human myeloid cancers and T-cell lymphoma. TET proteins are involved in the epigenetic control of transcription, at least through the…
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Editorial
Mutations in RNA Splicing Machinery in Human Cancers
Massively parallel sequencing of cancer genomes is revealing a panoramic view of the genetic drivers of human neoplasms. In this issue of the Journal, Wang et al. describe an analysis of the coding sequences of samples from 91 patients with chronic lymphocytic leukemia. The disease is characterized…
Original Article
SF3B1 and Other Novel Cancer Genes in Chronic Lymphocytic Leukemia
Chronic lymphocytic leukemia is an incurable disease characterized by extensive clinical heterogeneity despite a common diagnostic immunophenotype (surface expression of CD19+, CD20+dim, CD5+, CD23+, and sIgMdim). Whereas the course of disease is indolent in some patients, it is steadily…
Perspective
The Emperor of All Maladies — The Beginning of the Beginning
Richard Feynman, the eminent physicist, once said that "great ideas . . . do not last unless they are passed purposely and clearly from generation to generation." In 1979, Horace Freeland Judson, in his magnificent The Eighth Day of Creation, passed to his generation the great ideas of molecular…
- Audio
Correspondence
Myeloma and Second Primary Cancers
To the Editor: In December 2010, results from three randomized, phase 3 trials of treatments for multiple myeloma showed an excess of hematologic cancers among patients with multiple myeloma who received lenalidomide maintenance therapy (see Table 1 in the Supplementary Appendix, available with the…
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Acute leukemia after myeloma has been attributed to exposure to alkylating agents. However, leukemia is now being seen in patients receiving lenalidomide maintenance therapy. Patients with monoclonal gammopathy of undetermined significance also have an increased risk of leukemia without ever being treated.
Editorial
Eliminating Cells Gone Astray
The therapeutic use of cells from healthy donors or patients is increasing. Decades ago, transfusion medicine and bone marrow transplantation provided the first successful cell therapeutics and established the foundations for cell delivery. Clinical investigation soon uncovered the double-edged…
Original Article
Inducible Apoptosis as a Safety Switch for Adoptive Cell Therapy
Although cellular therapies may be effective in cancer treatment, their potential for expansion, damage of normal organs,– and malignant transformation is a source of concern. In contrast, the toxic effects of small molecules usually diminish once the drugs are withdrawn. One approach to…
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Clinical Practice
Adult Primary Care after Childhood Acute Lymphoblastic Leukemia
Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations. Stage. A 26-year-old…
- CME
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