Characteristics of RAS pathway mutations in juvenile myelomonocytic leukaemia: a single-institution study from Korea

Advances and challenges in gene therapy strategies for pediatric cancer: a comprehensive update

Pediatric cancers represent a tragic but also promising area for gene therapy. Although conventional treatments have improved survival rates, there is still a need for targeted and less toxic interventions. This article critically analyzes recent advances in gene therapy for pediatric malignancies and discusses the challenges that remain. We explore the innovative vectors and delivery systems that have emerged, such as adeno-associated viruses and non-viral platforms, which show promise in addressing the unique pathophysiology of pediatric tumors. Specifically, we examine the field of chimeric antigen receptor (CAR) T-cell therapies and their adaptation for solid tumors, which historically have been more challenging to treat than hematologic malignancies. We also discuss the genetic and epigenetic complexities inherent to pediatric cancers, such as tumor heterogeneity and the dynamic tumor microenvironment, which pose significant hurdles for gene therapy. Ethical considerations specific to pediatric populations, including consent and long-term follow-up, are also analyzed. Additionally, we scrutinize the translation of research from preclinical models that often fail to mimic pediatric cancer biology to the regulatory landscapes that can either support or hinder innovation. In summary, this article provides an up-to-date overview of gene therapy in pediatric oncology, highlighting both the rapid scientific progress and the substantial obstacles that need to be addressed. Through this lens, we propose a roadmap for future research that prioritizes the safety, efficacy, and complex ethical considerations involved in treating pediatric patients. Our ultimate goal is to move from incremental advancements to transformative therapies.

The impact of SETBP1 mutations in neurological diseases and cancer

SE translocation (SET) is a cancer-promoting factor whose expression is upregulated in many cancers. High SET expression positively correlates with a poor cancer prognosis. SETBP1 (SET-binding protein 1/SEB/MRD29), identified as SET-binding protein, is the causative gene of Schinzel-Giedion syndrome, which is characterized by severe intellectual disability and a distorted facial appearance. Mutations in these genetic regions are also observed in some blood cancers, such as myelodysplastic syndromes, and are associated with a poor prognosis. However, the physiological role of SETBP1 and the molecular mechanisms by which the mutations lead to disease progression have not yet been fully elucidated. In this review, we will describe the current epidemiological data on SETBP1 mutations and shed light on the current knowledge about the SET-dependent and -independent functions of SETBP1.

Haploidentical hematopoietic stem cell transplantation as promising therapy in the improved survival of pediatric patients with leukemias and myelodysplasias

BACKGROUND

Haploidentical hematopoietic stem cell transplantation (Haplo-HSCT) is often performed in children with hematologic malignancies. Faced with the gap in the literature regarding the approach to experiences related to Haplo-HSCT with pediatric patients with leukemias and myelodysplasias aged up to 18 years, there was an interest in exploring the clinical outcomes of patients undergoing this treatment.

AIM

To identify and summarize the scientific contributions available on Haplo-HSCT performed in the last 10 years in children and adolescents with myeloid and lymphoid leukemias and myelodysplasias, aged up to 18 years.

METHODS

This is a descriptive systematic review. We extracted data including characteristics of participants, health condition, characteristics of the donation, conditioning regimen, recurrent clinical complications and clinical outcomes. The Virtual Health Library Brazil, PubMed, EMBASE, and SciELO platforms were used, finding a total of 1052 studies. After the eligibility criteria and complete reading of the texts, 18 articles were included for analysis.

RESULTS

The total sample of all study cohorts was 1825 patients, mostly male, the highest reported median age was 15.0 years and the lowest was 1.2 years. Acute graft-versus-host disease and chronic graft-versus-host disease were observed in almost all studies. Relapse, graft rejection and delayed immune recovery were identified as major clinical challenges. Pre-transplant minimal positive residual disease was identified in 288 patients. Infections are also among the main clinical complications, viral, bacterial and fungal infections being reported. It is observed that in the 5-year interval, the lowest rates of EFS and overall survival (OS) were 29.5% and 68.0%, respectively. While, the highest rates of EFS and OS, in the same interval, were 80.1% and 81.0%.

CONCLUSION

Haplo-HSCT represents a promising therapy, considering the potential number of possible donors and the conditioning and treatment platforms that can be offered. The results obtained show that this type of transplant has a strong antileukemic effect, with generally favorable OS rates. Overcoming relapse as the first cause of transplant failure is the great clinical challenge.

The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Myeloid and Histiocytic/Dendritic Neoplasms

The upcoming 5th edition of the World Health Organization (WHO) Classification of Haematolymphoid Tumours is part of an effort to hierarchically catalogue human cancers arising in various organ systems within a single relational database. This paper summarizes the new WHO classification scheme for myeloid and histiocytic/dendritic neoplasms and provides an overview of the principles and rationale underpinning changes from the prior edition. The definition and diagnosis of disease types continues to be based on multiple clinicopathologic parameters, but with refinement of diagnostic criteria and emphasis on therapeutically and/or prognostically actionable biomarkers. While a genetic basis for defining diseases is sought where possible, the classification strives to keep practical worldwide applicability in perspective. The result is an enhanced, contemporary, evidence-based classification of myeloid and histiocytic/dendritic neoplasms, rooted in molecular biology and an organizational structure that permits future scalability as new discoveries continue to inexorably inform future editions.