Genetic Ancestry and Childhood Acute Lymphoblastic Leukemia Subtypes and Outcomes in the Genomic Era
Menée auprès de 2 318 enfants et adolescents atteints d'une leucémie lymphoblastique aiguë, cette étude multicentrique évalue l'association entre l'ascendance génétique, le sous-type moléculaire de la maladie et le pronostic
Racial and ethnic differences have long been recognized in both the incidence of childhood acute lymphoblastic leukemia (ALL) subtypes and in treatment outcomes. However, comprehensive modern studies in this area are lacking, despite substantial advances in other areas of ALL research in the past decade. Next-generation sequencing has led to a dramatic expansion in the taxonomy of ALL, particularly in B-cell ALL. The uncharacterized B-other category has steadily shrunk as numerous novel alterations have been identified based on a variety of alterations, including cryptic gene rearrangements, gene expression signatures, and point variants. In addition, ALL outcomes have continued to steadily improve over the past decade owing to factors that include refinements in risk stratification, improved detection of minimal residual disease, optimization of conventional chemotherapy regimens, development of novel targeted therapies and immunotherapies, and enhancements in supportive care. Finally, the advent of genetic ancestry for determination of race and ethnicity allows for greater complexity in studying degrees of admixture compared with studies based only on self-report.
JAMA Oncology , éditorial, 2021