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Low dose decitabine in very high risk relapsed or refractory acute myeloid leukaemia in children and young adults

TLDR
Low‐dose decitabine has encouraging activity and tolerability in adults with acute myeloid leukaemia (AML), but paediatric experience is lacking, and eight patients with refractory/relapsed AML are reported on.
Abstract
Low-dose decitabine has encouraging activity and tolerability in adults with acute myeloid leukaemia (AML), but paediatric experience is lacking. We report our retrospective experience with decitabine in eight children and young adults (median age 4 years) with refractory/relapsed AML, who had failed multiple regimens or were not candidates for standard retrieval regimens due to prior toxicities. Three of eight patients (38%) had complete response (CR; 1 each of CR, CR with incomplete platelet recovery and CR with incomplete count recovery). Best responses were observed after a median of 2.5 cycles (range 1-4 cycles). Four patients received subsequent allogeneic stem cell transplant, and two remain in long-term CR.

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Pediatric AML: From Biology to Clinical Management

TL;DR: These efforts towards future personalized therapy in a rare disease, such as pediatric AML, require intensive international collaboration in order to enhance the survival rates of Pediatrics, while aiming to reduce long-term toxicity.
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Genetic predisposition to myelodysplastic syndrome and acute myeloid leukemia in children and young adults

TL;DR: A practical algorithm for approaching a patient with a suspected MDS/AML predisposition, and an in-depth review of the established and emerging familial MDS-AML syndromes caused by mutations in the ANKRD26, CEBPA, DDX41, ETV6, GATA2, RUNX1, SRP72 genes are provided.
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Oncogenic Roles and Inhibitors of DNMT1, DNMT3A, and DNMT3B in Acute Myeloid Leukaemia.

TL;DR: Hypermethylation of tumour suppressors mediated by DNMT1 or DNMT3B contributes to the progression and severity of AML (except MLL-AF9 and inv(16)(p13;q22) AML for DN MT3B), while mutation affecting DNMT2A represents an early genetic lesion in the pathogenesis of AMl.
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5-Azacytidine and DLI can induce long-term remissions in AML patients relapsed after allograft

TL;DR: Long-term remissions can be induced by this well-tolerated outpatient treatment, particularly in patients without peripheral blood blasts, as well as upregulating Ags on blasts before DLI.
References
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Journal ArticleDOI

Revised Recommendations of the International Working Group for Diagnosis, Standardization of Response Criteria, Treatment Outcomes, and Reporting Standards for Therapeutic Trials in Acute Myeloid Leukemia

TL;DR: An International Working Group met to revise the diagnostic and response criteria for acute myelogenous leukemia originally published in 1990, as well as to provide definitions of outcomes and reporting standards to improve interpretability of data and comparisons among trials as mentioned in this paper.
Journal ArticleDOI

5-Azacytidine and 5-aza-2'-deoxycytidine as inhibitors of DNA methylation: mechanistic studies and their implications for cancer therapy.

TL;DR: The current status of the understanding of the mechanism(s) by which 5-azacytosine residues in DNA inhibit DNA methylation is reviewed with an emphasis on the interactions of these residues with bacterial and mammalian DNA (cytosines-C5) methyltransferases.
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