Involvement of the central nervous system in acute lymphoblastic leukemia: opinions on molecular mechanisms and clinical implications based on recent data.
Cancer Metastasis Rev
; 39(1): 173-187, 2020 03.
Article
in En
| MEDLINE
| ID: mdl-31970588
ABSTRACT
Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. One of the major clinical challenges is adequate diagnosis and treatment of central nervous system (CNS) involvement in this disease. Intriguingly, there is little solid evidence on the mechanisms sustaining CNS disease in ALL. Here, we present and discuss recent data on this topic, which are mainly derived from preclinical model systems. We thereby highlight sites and routes of leukemic CNS infiltration, cellular features promoting infiltration and survival of leukemic cells in a presumably hostile niche, and dormancy as a potential mechanism of survival and relapse in CNS leukemia. We also focus on the impact of ALL cytogenetic subtypes on features associated with a particular CNS tropism. Finally, we speculate on new perspectives in the treatment of ALL in the CNS, including ideas on the impact of novel immunotherapies.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Central Nervous System
/
Leukemic Infiltration
/
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Limits:
Child
/
Humans
Language:
En
Journal:
Cancer Metastasis Rev
Journal subject:
NEOPLASIAS
Year:
2020
Document type:
Article
Affiliation country:
Germany