Biologie moléculaire : accès libre

Implications of basic research in clinical practice: toward a personalized medicine in T-cell Acute Lymphoblastic Leukemia (T-ALL)

Abstract

Guillem Berbis, Jordi Ribera, Josep Maria Ribera and Eulàlia Genescà

Acute Lymphoblastic Leukemia (ALL) is the most common cancer in children and one of the main causes of death among childhood blood disorders. There are two subtypes according to the affected lymphoid progenitor: B-ALL and T-ALL. The T-ALL is the less common and historically was associated with poor prognosis in both adults and children, although at present, treatment outcomes do not differ significantly between the two types of ALL. The T-ALL subtype is the most complex and heterogeneous at the genetic level and currently the one with less new therapeutic alternatives available. This trend is changing thanks to the remarkable progress that is being made in understanding the biology involved. Advances in genomic research during last decade have largely contributed to this progress. Moreover many efforts are being made to identify which of this new basic data is relevant for clinical practice. This will allow us to better define the risk and take decisions on the best treatment to apply to each patient. Therefore we are moving towards a personalized patient management that ultimately will result in an increase in survival and progress to T-ALL cure. This review summarizes the most relevant and applicable biological findings in T-ALL made in recent years and their therapeutic implications that will influence the clinical practice in the future.