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Vacek M, Zárraga Vargas LC, González Domínguez E, Garcia Rodriguez L, Tello Teran OA, Mojica Cardoso C, Ocampo Roosens LV, Acevedo Fernandez JJ, Li W, Lee B, Olalla Tapia JS, Flatt T. Increased Incidence of TdT-negative Pre-B Acute Lymphoblastic Leukemia Associated With Poor Prognostic Features Among Mexican Children in Central Mexico. J Pediatr Hematol Oncol 2024; 46:e131-e136. [PMID: 38132672 DOI: 10.1097/mph.0000000000002802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023]
Abstract
Mexican and Hispanic children in Mexico and the United States, respectively, have the highest incidence and worst outcomes of pre-B acute lymphoblastic leukemia (ALL) compared with other racial/ethnic groups. Terminal deoxynucleotidyl transferase (TdT) is an intranuclear DNA polymerase normally present on immature lymphocytes (TdT-positive) and distinguishes ALL from mature lymphoid malignancies. We performed a multisite retrospective study to determine the incidence of TdT-negative precursor B-cell acute lymphoblastic leukemia (pre-B ALL) among Mexican, Caucasian, and US-born Hispanic children to correlate TdT expression with patient characteristics and known prognostic factors. Fisher exact test was performed for categorical variables and the Wilcoxon rank-sum test was used for continuous variables. TdT-negative pre-B ALL was most frequently identified in patients with National Cancer Institute high-risk disease ( P =0.014). TdT-negative expression was also most frequently associated with hypodiploid pre-B ALL ( P =0.001) and KMT2A gene rearrangement ( P =0.0012). Mexican children had the highest incidence of TdT-negative ALL compared with Caucasians and US Hispanics ( P <0.001), with an increased incidence of poor prognostic features as well. This study demonstrates significant differences in TdT-negative expression, genomic alterations, and leukemic ploidy based on race and ethnicity.
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Affiliation(s)
- Meagan Vacek
- Department of Pediatric Hematology-Oncology, Children's Mercy Hospital, Kansas City, MO
| | - Laura C Zárraga Vargas
- Stem Cell Biology Lab, Autonomous University of Morelos State, Cuernavaca
- The Dr. Ruy Perez Tamayo Diagnostic and Molecular Medicine Unit, Hospital del Niño Morelense, Emiliano Zapata
| | | | | | | | | | | | | | | | - Brian Lee
- Division of Health Services and Outcomes Research, Children's Mercy Hospital, Kansas City, MO
| | - Jesús S Olalla Tapia
- Stem Cell Biology Lab, Autonomous University of Morelos State, Cuernavaca
- The Dr. Ruy Perez Tamayo Diagnostic and Molecular Medicine Unit, Hospital del Niño Morelense, Emiliano Zapata
| | - Terrie Flatt
- Department of Pediatric Hematology-Oncology, Children's Mercy Hospital, Kansas City, MO
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Romo-Rodríguez R, Zamora-Herrera G, López-Blanco JA, López-García L, Rosas-Cruz A, Alfaro-Hernández L, Trejo-Pichardo CO, Alberto-Aguilar DR, Casique-Aguirre D, Vilchis-Ordoñez A, Solis-Poblano JC, García-Stivalet LA, Terán-Cerqueda V, Luna-Silva NC, Garrido-Hernández MÁ, Cano-Cuapio LS, Ayala-Contreras K, Domínguez F, del Campo-Martínez MDLÁ, Juárez-Avendaño G, Balandrán JC, Pérez-Tapia SM, Fernández-Giménez C, Zárate-Rodríguez PA, López-Aguilar E, Treviño-García A, Duque-Molina C, Bonifaz LC, Núñez-Enríquez JC, Cárdenas-González M, Álvarez-Buylla ER, Ramírez-Ramírez D, Pelayo R. Subclassification of B-acute lymphoblastic leukemia according to age, immunophenotype and microenvironment, predicts MRD risk in Mexican children from vulnerable regions. Front Oncol 2024; 13:1304662. [PMID: 38250553 PMCID: PMC10796993 DOI: 10.3389/fonc.2023.1304662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/01/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction The decisive key to disease-free survival in B-cell precursor acute lymphoblastic leukemia in children, is the combination of diagnostic timeliness and treatment efficacy, guided by accurate patient risk stratification. Implementation of standardized and high-precision diagnostic/prognostic systems is particularly important in the most marginalized geographic areas in Mexico, where high numbers of the pediatric population resides and the highest relapse and early death rates due to acute leukemias are recorded even in those cases diagnosed as standard risk. Methods By using a multidimensional and integrated analysis of the immunophenotype of leukemic cells, the immunological context and the tumor microenvironment, this study aim to capture the snapshot of acute leukemia at disease debut of a cohort of Mexican children from vulnerable regions in Puebla, Oaxaca and Tlaxcala and its potential use in risk stratification. Results and discussion Our findings highlight the existence of a distinct profile of ProB-ALL in children older than 10 years, which is associated with a six-fold increase in the risk of developing measurable residual disease (MRD). Along with the absence of CD34+ seminal cells for normal hematopoiesis, this ProB-ALL subtype exhibited several characteristics related to poor prognosis, including the high expression level of myeloid lineage markers such as MPO and CD33, as well as upregulation of CD19, CD34, CD24, CD20 and nuTdT. In contrast, it showed a trend towards decreased expression of CD9, CD81, CD123, CD13, CD15 and CD21. Of note, the mesenchymal stromal cell compartment constituting their leukemic niche in the bone marrow, displayed characteristics of potential suppressive microenvironment, such as the expression of Gal9 and IDO1, and the absence of the chemokine CXCL11. Accordingly, adaptive immunity components were poorly represented. Taken together, our results suggest, for the first time, that a biologically distinct subtype of ProB-ALL emerges in vulnerable adolescents, with a high risk of developing MRD. Rigorous research on potential enhancing factors, environmental or lifestyle, is crucial for its detection and prevention. The use of the reported profile for early risk stratification is suggested.
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Affiliation(s)
- Rubí Romo-Rodríguez
- Laboratorio de Citómica del Cáncer Infantil, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Gabriela Zamora-Herrera
- Laboratorio de Citómica del Cáncer Infantil, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Jebea A. López-Blanco
- Laboratorio de Citómica del Cáncer Infantil, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Lucero López-García
- Laboratorio de Citómica del Cáncer Infantil, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Arely Rosas-Cruz
- Laboratorio de Citómica del Cáncer Infantil, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Laura Alfaro-Hernández
- Laboratorio de Citómica del Cáncer Infantil, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
- Facultad de Ciencias Químicas, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - César Omar Trejo-Pichardo
- Laboratorio de Citómica del Cáncer Infantil, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Dulce Rosario Alberto-Aguilar
- Laboratorio de Citómica del Cáncer Infantil, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
- Consejo Nacional de Humanidades, Ciencias y Tecnologías (CONAHCYT), Mexico City, Mexico
| | - Diana Casique-Aguirre
- Laboratorio de Citómica del Cáncer Infantil, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
- Consejo Nacional de Humanidades, Ciencias y Tecnologías (CONAHCYT), Mexico City, Mexico
| | - Armando Vilchis-Ordoñez
- Laboratorio de Citómica del Cáncer Infantil, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
- Hospital Infantil de México ‘Federico Gómez’, Secretaría de Salud, Mexico City, Mexico
| | - Juan Carlos Solis-Poblano
- Servicio de Hematología, Unidad Médica de Alta Especialidad, Hospital de Especialidades “Manuel Avila Camacho”, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Lilia Adela García-Stivalet
- Servicio de Hematología, Unidad Médica de Alta Especialidad, Hospital de Especialidades “Manuel Avila Camacho”, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Vanessa Terán-Cerqueda
- Servicio de Hematología, Unidad Médica de Alta Especialidad, Hospital de Especialidades “Manuel Avila Camacho”, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | | | | | | | - Karen Ayala-Contreras
- Laboratorio de Citómica del Cáncer Infantil, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Fabiola Domínguez
- Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | | | | | - Juan Carlos Balandrán
- Department of Pathology, New York University (NYU) School of Medicine, New York, NY, United States
| | - Sonia Mayra Pérez-Tapia
- Unidad de Desarrollo e Investigación en Bioterapéuticos (UDIBI), Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Carlos Fernández-Giménez
- Cancer Research Center-Instituto de Biología Molecular y Celular del Cáncer-Universidad de Salamanca-Centro Superior de Investigaciones Científicas (IBMCC-USAL-CSIC), Department of Medicine and Cytometry Service-Nucleus Platform, Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Biomedical Research Institute of Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | | | - Enrique López-Aguilar
- Coordinación de Atención Oncológica, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Aurora Treviño-García
- Organo de Operación Administrativa Desconcentrada, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Célida Duque-Molina
- Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Laura C. Bonifaz
- Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Juan Carlos Núñez-Enríquez
- Unidad Médica de Alta Especialidad (UMAE) Hospital de Pediatría “Dr. Silvestre Frenk Freund” Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | | | - Dalia Ramírez-Ramírez
- Laboratorio de Citómica del Cáncer Infantil, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Rosana Pelayo
- Laboratorio de Citómica del Cáncer Infantil, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social, Puebla, Mexico
- Unidad de Educación e Investigación, Instituto Mexicano del Seguro Social, Mexico City, Mexico
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Mata-Rocha M, Rangel-López A, Jimenez-Hernandez E, Nuñez-Enríquez JC, Morales-Castillo BA, Sánchez-Escobar N, Sepúlveda-Robles OA, Bravata-Alcántara JC, Nájera-Cortés AS, Pérez-Saldivar ML, Flores-Lujano J, Duarte-Rodríguez DA, Oviedo de Anda NA, Romero Tlalolini MDLA, Alaez Verson C, Martín-Trejo JA, Muñoz Medina JE, Gonzalez-Bonilla CR, Hernandez Cueto MDLA, Bekker-Méndez VC, Jiménez-Morales S, Medina-Sansón A, Amador-Sánchez R, Peñaloza-González JG, Torres-Nava JR, Espinosa-Elizondo RM, Cortés-Herrera B, Flores-Villegas LV, Merino-Pasaye LE, Gutierrez-Rivera MDL, Velazquez-Aviña MM, Santillan-Juarez JD, Gurrola-Silva A, Hernández Echáurregui GA, Hidalgo-Miranda A, Arellano Galindo J, Rosas-Vargas H, Mejía-Aranguré JM. Low Prevalence of ETV6::RUNX1 Fusion Gene in a Hispanic Population. Front Pediatr 2022; 10:837656. [PMID: 35685921 PMCID: PMC9171364 DOI: 10.3389/fped.2022.837656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
ETV6::RUNX1 is a genetic rearrangement of good prognosis in children with acute lymphoblastic leukemia (ALL). In Mexico, its prevalence is low in comparison with Caucasian populations. We developed a novel TaqMan one-step RT-qPCR approach to assess the prevalence of four genetic rearrangements in a cohort of Hispanic children with ALL from Mexico City. The prevalence of common fusion gene transcripts was as follows: TCF3::PBX1 7.7%; BCR::ABL1p 190 3.3%; and KMT2A::AFF1 2.8%, and ETV6::RUNX1was observed with low prevalence (10.5%) in comparison to that reported for developed countries. This is consistent with previous findings on Mexican children with ALL and similar to those reported on children from Hispanic populations. The confirmation of a low prevalence of ETV6::RUNX1 in children of a Hispanic origin represents an advancement in the description of genetic factors of ALL in these populations.
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Affiliation(s)
- Minerva Mata-Rocha
- CONACyT-Unidad de Investigacion Medica en Genetica Humana, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
| | - Angelica Rangel-López
- Coordinacion de Investigacion en Salud, Unidad Habilitada de Apoyo al Predictamen, Centro Medico Siglo XXI, IMSS, Mexico City, Mexico
| | - Elva Jimenez-Hernandez
- Servicio de Hematologia Pediatrica, Hospital General “Gaudencio González Garza”, Centro Medico Nacional (CMN) “La Raza”, IMSS, Mexico City, Mexico
| | - Juan Carlos Nuñez-Enríquez
- Unidad de Investigacion Medica en Epidemiologia Clinica, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
| | - Blanca Angélica Morales-Castillo
- Unidad de Investigacion Medica en Genética Humana, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
| | - Norberto Sánchez-Escobar
- Unidad de Investigacion Medica en Genética Humana, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
- Facultad de Medicina y Cirugía, UABJO, Oaxaca, Mexico
| | - Omar Alejandro Sepúlveda-Robles
- Unidad de Investigacion Medica en Genética Humana, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
| | - Juan Carlos Bravata-Alcántara
- Laboratorio de Genética y Diagnóstico Molecular, Hospital Juárez de México, Secretaría de Salud (SSa), Mexico City, Mexico
| | - Alan Steve Nájera-Cortés
- Laboratorio de Genética y Diagnóstico Molecular, Hospital Juárez de México, Secretaría de Salud (SSa), Mexico City, Mexico
| | - María Luisa Pérez-Saldivar
- Unidad de Investigacion Medica en Epidemiologia Clinica, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
| | - Janet Flores-Lujano
- Unidad de Investigacion Medica en Epidemiologia Clinica, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
| | - David Aldebarán Duarte-Rodríguez
- Unidad de Investigacion Medica en Epidemiologia Clinica, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
| | | | | | - Carmen Alaez Verson
- Laboratorio de Diagnóstico Genómico, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
| | - Jorge Alfonso Martín-Trejo
- Servicio de Hematologia, UMAE Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
| | - Jose Esteban Muñoz Medina
- Laboratorio Central de Epidemiología, Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Maria de los Angeles Hernandez Cueto
- Centro Médico Nacional La Raza, División de Laboratorios de Vigilancia e Investigación Epidemiológica, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - VC. Bekker-Méndez
- UIM en Inmunología e Infectología, Centro Médico Nacional “La Raza”, IMSS, Mexico City, Mexico
| | - Silvia Jiménez-Morales
- Laboratorio de Genomica del Cancer, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - Aurora Medina-Sansón
- Servicio de Oncología, Hospital Infantil de Mexico Federico Gómez, Secretaria de Salud, Mexico City, Mexico
| | - Raquel Amador-Sánchez
- Servicio de Hematologia Pediatrica, Hospital General Regional “Carlos McGregor Sanchez Navarro”, IMSS, Mexico City, Mexico
| | | | - José Refugio Torres-Nava
- Servicio de Oncología, Hospital Pediatrico de Moctezuma, Secretaria de Salud de la Ciudad de Mexico (SSCDMX), Mexico City, Mexico
| | | | - Beatriz Cortés-Herrera
- Servicio de Hematologia Pediatrica, Hospital General de Mexico, Secretaria de Salud, Mexico City, Mexico
| | | | | | | | | | | | - Alma Gurrola-Silva
- Servicio de Pediatría, Hospital Regional Tipo B de Alta Especialidad Bicentenario de la Independencia, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado, Mexico City, Mexico
| | | | - Alfredo Hidalgo-Miranda
- Laboratorio de Genomica del Cancer, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
| | - José Arellano Galindo
- Unidad de Investigación en Enfermedades Infecciosas, Laboratorio de Virologia Clínica y Experimental, Hospital Infantil de Mexico Federico Gómez, Secretaria de Salud, Mexico City, Mexico
| | - Haydeé Rosas-Vargas
- Unidad de Investigacion Medica en Genética Humana, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
| | - Juan Manuel Mejía-Aranguré
- Unidad de Investigacion Medica en Genética Humana, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
- Laboratorio de Genomica del Cancer, Instituto Nacional de Medicina Genómica, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Balandrán JC, Dávila-Velderrain J, Sandoval-Cabrera A, Zamora-Herrera G, Terán-Cerqueda V, García-Stivalet LA, Limón-Flores JA, Armenta-Castro E, Rodríguez-Martínez A, Leon-Chavez BA, Vallejo-Ruiz V, Hassane DC, Pérez-Tapia SM, Ortiz-Navarrete V, Guzman ML, Pelayo R. Patient-Derived Bone Marrow Spheroids Reveal Leukemia-Initiating Cells Supported by Mesenchymal Hypoxic Niches in Pediatric B-ALL. Front Immunol 2021; 12:746492. [PMID: 34737747 PMCID: PMC8561951 DOI: 10.3389/fimmu.2021.746492] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/14/2021] [Indexed: 12/13/2022] Open
Abstract
B-cell acute lymphoblastic leukemia (B-ALL) results from the expansion of malignant lymphoid precursors within the bone marrow (BM), where hematopoietic niches and microenvironmental signals provide leukemia-initiating cells (LICs) the conditions to survive, proliferate, initiate disease, and relapse. Normal and malignant lymphopoiesis are highly dependent on the BM microenvironment, particularly on CXCL12-abundant Reticular (CAR) cells, which provide a niche for maintenance of primitive cells. During B-ALL, leukemic cells hijack BM niches, creating a proinflammatory milieu incompetent to support normal hematopoiesis but favoring leukemic proliferation. Although the lack of a phenotypic stem cell hierarchy is apparent in B-ALL, LICs are a rare and quiescent population potentially responsible for chemoresistance and relapse. Here, we developed novel patient-derived leukemia spheroids (PDLS), an ex vivo avatar model, from mesenchymal stromal cells (MSCs) and primary B-ALL cells, to mimic specialized niche structures and cell-to-cell intercommunication promoting normal and malignant hematopoiesis in pediatric B-ALL. 3D MSC spheroids can recapitulate CAR niche-like hypoxic structures that produce high levels of CXCL10 and CXCL11. We found that PDLS were preferentially enriched with leukemia cells displaying functional properties of LICs, such as quiescence, low reactive oxygen species, drug resistance, high engraftment in immunodeficient mice, and long-term leukemogenesis. Moreover, the combination of PDLS and patient-derived xenografts confirmed a microenvironment-driven hierarchy in their leukemic potential. Importantly, transcriptional profiles of MSC derived from primary patient samples revealed two unique signatures (1), a CXCL12low inflammatory and leukemia expansion (ILE)-like niche, that likely supports leukemic burden, and (2) a CXCL11hi immune-suppressive and leukemia-initiating cell (SLIC)-like niche, where LICs are likely sustained. Interestingly, the CXCL11+ hypoxic zones were recapitulated within the PDLS that are capable of supporting LIC functions. Taken together, we have implemented a novel PDLS system that enriches and supports leukemia cells with stem cell features driven by CXCL11+ MSCs within hypoxic microenvironments capable of recapitulating key features, such as tumor reemergence after exposure to chemotherapy and tumor initiation. This system represents a unique opportunity for designing ex vivo personalized avatars for B-ALL patients to evaluate their own LIC pathobiology and drug sensitivity in the context of the tumor microenvironment.
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Affiliation(s)
- Juan Carlos Balandrán
- Laboratorio de Oncoinmunología y Citómica, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social Delegación Puebla, Puebla, Mexico
- Departamento de Biomedicina Molecular, Centro de Investigación y de Estudios Avanzados (CINVESTAV), Mexico City, Mexico
| | - José Dávila-Velderrain
- Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology (MIT), Cambridge, MA, United States
- The Broad Institute of MIT and Harvard, Cambridge, MA, United States
| | - Antonio Sandoval-Cabrera
- Hospital para el Niño de Toluca, Instituto Materno Infantil del Estado de México (IMIEM), Toluca, Mexico
| | - Gabriela Zamora-Herrera
- Laboratorio de Oncoinmunología y Citómica, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social Delegación Puebla, Puebla, Mexico
| | - Vanessa Terán-Cerqueda
- Servicio de Hematología, Unidad Médica de Alta Especialidad, Hospital de Especialidades “Manuel Ávila Camacho”, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Lilia Adela García-Stivalet
- Servicio de Hematología, Unidad Médica de Alta Especialidad, Hospital de Especialidades “Manuel Ávila Camacho”, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - José Alejandro Limón-Flores
- Servicio de Hematología, Unidad Médica de Alta Especialidad, Hospital de Especialidades “Manuel Ávila Camacho”, Instituto Mexicano del Seguro Social, Puebla, Mexico
| | - Erick Armenta-Castro
- Laboratorio de Oncoinmunología y Citómica, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social Delegación Puebla, Puebla, Mexico
| | - Aurora Rodríguez-Martínez
- Laboratorio de Oncoinmunología y Citómica, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social Delegación Puebla, Puebla, Mexico
- Posgrado en Ciencias Químicas, Area de Bioquímica y Biología Molecular, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Bertha Alicia Leon-Chavez
- Posgrado en Ciencias Químicas, Area de Bioquímica y Biología Molecular, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Verónica Vallejo-Ruiz
- Laboratorio de Oncoinmunología y Citómica, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social Delegación Puebla, Puebla, Mexico
| | - Duane C. Hassane
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Sonia Mayra Pérez-Tapia
- Unidad de Desarrollo e Investigación en Bioprocesos (UDIBI) and Unidad de Investigación, Desarrollo e Innovación Médica y Biotecnológica (UDIMEB), Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Vianney Ortiz-Navarrete
- Departamento de Biomedicina Molecular, Centro de Investigación y de Estudios Avanzados (CINVESTAV), Mexico City, Mexico
| | - Monica L. Guzman
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Rosana Pelayo
- Laboratorio de Oncoinmunología y Citómica, Centro de Investigación Biomédica de Oriente, Instituto Mexicano del Seguro Social Delegación Puebla, Puebla, Mexico
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Childhood Acute Leukemias in Developing Nations: Successes and Challenges. Curr Oncol Rep 2021; 23:56. [PMID: 33755790 DOI: 10.1007/s11912-021-01043-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Acute leukemias represent a tremendous threat to public health around the globe and the main cause of death due to disease in scholar age children from developing nations. Here, we review their current status in Mexico, as a paradigm of study, and the major challenges to control systemic diseases like childhood cancer. RECENT FINDINGS A unique molecular epidemiology, late/low precision diagnosis, limited access to treatment, toxicity associated with therapy, continuous exposure to environmental risk factors, and the high frequency of early relapses are some of the factors cooperating to low rates of survival in low-to-medium-income countries. Deliberative dialogues and exhaustive programs have emerged as promising means of advancing evidence-informed policy, by providing a structured forum for key stakeholders to integrate scientific and pragmatic knowledge about complex health concerns. A system-wide strategy based on the comprehensive leukemia identity is essential for a meaningful decline in early childhood mortality.
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Vilchis-Ordoñez A, Ramírez-Ramírez D, Pelayo R. The triad inflammation-microenvironment-tumor initiating cells in leukemia progression. CURRENT OPINION IN PHYSIOLOGY 2021. [DOI: 10.1016/j.cophys.2020.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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