my name aside can vary and i'm a felon he mythology and an ecology at
the man clinical rochester
and then assistant professor of madison
and quality of the male clinic college of madison
i'll be discussing a recent paper entitled at you can for plastic leukaemia and adolescents
and young adults from genomics to the clinics
the seen your author of this paper is doctor marked with so
you'd look for plastic looking man and all sensing younger adults
represents a unique and challenging disease and data for multiple reasons
this by there is an improvement in survival in this population
is still lagging behind compared to the excellent your rates in paediatric a well
a reason analysis of this year database
sure that the five year survival in this population was only sixty three percent compared
to eighty seven percent in children up to fifteen years of age
the reasons for this significant difference in survival are complex and not fully understood
there are substantial differences in disease biology response to chemotherapy
role of religion extends all transplantation
and novel therapy you know this group
several biological differences between paediatric i l and l and adolescents and young adults have
been described
first of all
genetic alterations associated with good prognosis
so it's just for hyper deplore d and trance location twelve twenty one
bikinis in frequency with age well tourist site again ticks increasing prevalence
in addition to that even good risk side the genetics such as type are deployed
be
are associated with inferior outcomes
and adolescents and young adults compared to their counterpart in children
patients between fifteen and thirty years of age have higher rates
of
minimal residual disease burden after chemotherapy compared to children
there is also higher incidence of
early precursor t cell a low
and adolescents and young adults
which is generally defined and eighty characterized by inferior outcomes and poor response to chemotherapy
several studies have reported the genomic profiling and bit in paediatric patients with a well
well no focus genomic analysis of idle sensing younger adults has been performed
these patients what are frequently included in paediatric studies
their genetic profile was similar to patients with high risk a l
for example
jack mediation
intra chromosome amplification of chromosome twenty one
and b c r a b a like a level where frequent findings
in addition to the difference in biology
between paediatric a allow and l and adolescents and young adults
several analyses have shown survival benefits
when these patients are treated on paediatric intense compared to adult protocols
the reasons for this are not clear and likely to be mode a factorial
including
earlier introduction of c n as direct if the wrapping paediatric protocols
the use of more intense chemotherapy
and higher rates of compliance one adolescents are treated on paediatric protocols under the parents
supervision
the role of a logit mixed them so transplantation and adolescents and young adults with
a l is also controversial
there have been a prospective trials addressing this group
and subgroup analyses
from a little transplant trials have been controversial
and finally with the emergence of novel therapies and at all day l
i dollar sense and younger adults
are frequently included
in this clinical trials
they seem to experience benefit from such approaches
for example they benefited the most from a high degree talks a madman a pretty
be al
in early study is
in a two zone a poser got my as in
cluster opinion and their libyan
have also want to have activity
in early clinical trials and adolescents and young adult