Pediatrik öncü B-ALL’ye Moleküler Yaklaşım

Abstract

Lösemi, çocukluk çağında en sık görülen malign hastalıktır. Bu hastalık yaklaşık 150 yıl önce tanımlanmıştır, ancak son 30 yıllık süreçte tedavide %90’lara varan bir başarı oranına ulaşılabilmiştir. Bu başarılı sonuçlara ulaşılmasında çoklu ilaç uygulamaları, santral sinir sistemi profilaksisi, idame ve destek tedavi uygulamaları etkili olmuştur. Tedavide bu kadar başarılı sonuçların alınmasına rağmen nüks lösemi için bir risk olmaya devam etmekte ve ALL hastalarının %20’sinde görülmektedir. Tedaviden alınan farklı sonuçlar diğer bütün kanser tiplerinde olduğu gibi lösemi’nin de heterojen bir yapıya sahip olduğunu işaret etmektedir. Bu nedenle erken, doğru bir teşhis ile daha etkin bir tedavinin ancak kişiye özgü (hastalık alt gruplarına) tedavi, yöntem ve müdahale stratejilerinin geliştirilmesi ile mümkün olabileceği öngörülmektedir. Bu kapsamda diğer bütün kanser tiplerinde olduğu gibi “lösemi genomunda” yapısal ve/veya işlevsel bozukluk gösteren genler, lösemi tanısı, tedavisi ve nüksünün önlenebilmesi için yeni prognostik araçlar olabilme potansiyeli taşımaktadır.

Keywords

• Lösemi,prognostik biyobelirteç

Molecular Approach to Pediatric Precursor B-ALL

Abstract

Leukemia is the most common malignant disease in childhood. This disease was identified almost 150 years ago, but in the last 30 years, treatment processes have achieved a success rate of up to 90%. These successful outcomes were supported by multi-drug treatments, central nervous system prophylaxis, maintainability and therapeutic applications. Although successful treatment outcome relapse continues to be a risk for leukemia and is seen in 20% of patients with leukemia. In this case, all other types of cancers as well as leukemia have a structure that is heterogeneous. Therefore, individualized treatment methods are more effective than early accurate diagnosis, hence the development of individualised treatment methods and intervention strategies have become necessary. In this context, as in all other types of cancer the leukemia genome contain structural abnormalities several genes leading to their functional dysfunction. These genes have the potential to become novel biomarkers for diagnosis, prognosis, treatment and prevention of relapse.

Keywords

• Leukemia

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