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      Acute lymphoblastic leukaemia.

      Lancet

      Young Adult, Adolescent, Antineoplastic Agents, therapeutic use, Cell- and Tissue-Based Therapy, methods, Central Nervous System Diseases, therapy, Child, Child, Preschool, Chromosome Aberrations, Female, Forecasting, Gene Expression Profiling, Gene Frequency, Gene Rearrangement, B-Lymphocyte, Genetic Predisposition to Disease, genetics, Genome, Human, Hematopoietic Stem Cell Transplantation, Humans, Infant, Male, Precursor Cell Lymphoblastic Leukemia-Lymphoma, epidemiology, Prognosis, Recurrence, Remission Induction, Risk Assessment, Sequence Analysis, DNA, Transcription Factors, Translocation, Genetic, Treatment Outcome

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          Abstract

          Acute lymphoblastic leukaemia occurs in both children and adults but its incidence peaks between 2 and 5 years of age. Causation is multifactorial and exogenous or endogenous exposures, genetic susceptibility, and chance have roles. Survival in paediatric acute lymphoblastic leukaemia has improved to roughly 90% in trials with risk stratification by biological features of leukaemic cells and response to treatment, treatment modification based on patients' pharmacodynamics and pharmacogenomics, and improved supportive care. However, innovative approaches are needed to further improve survival while reducing adverse effects. Prognosis remains poor in infants and adults. Genome-wide profiling of germline and leukaemic cell DNA has identified novel submicroscopic structural genetic changes and sequence mutations that contribute to leukaemogenesis, define new disease subtypes, affect responsiveness to treatment, and might provide novel prognostic markers and therapeutic targets for personalised medicine. Copyright © 2013 Elsevier Ltd. All rights reserved.

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          Author and article information

          Journal
          23523389
          3816716
          10.1016/S0140-6736(12)62187-4

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