Outcome of children with multiply relapsed B-cell acute lymphoblastic leukemia: a therapeutic advances in childhood leukemia & lymphoma study.

The survival of pediatric patients with multiply relapsed and/or refractory (R/R) B-cell acute lymphoblastic leukemia has historically been very poor; however, data are limited in the current era. We conducted a retrospective study to determine the outcome of multiply R/R childhood B-ALL treated at 24 TACL institutions between 2005 and 2013. Patient information, treatment, and response were collected. Prognostic factors influencing the complete remission (CR) rate and event-free survival (EFS) were analyzed. The analytic set included 578 salvage treatment attempts among 325 patients. CR rates (mean ± SE) were 51 ± 4% for patients with bone marrow R/R B-ALL who underwent a second salvage attempt, 37 ± 6% for a third attempt, and 31 ± 6% for the fourth through eighth attempts combined. For patients achieving a CR after their second, third, and fourth through eighth attempts, the 2 year EFS was 41 ± 6%, 13 ± 7%, and 27 ± 13% respectively. Our results showed slight improvement when compared to previous studies. This is the largest and most recent study to date that evaluates the outcome of this patient population. Our data will provide detailed reference for the evaluation of new agents being developed for childhood B-ALL

Laetirobin from the parasitic growth of Laetiporus sulphureus on Robinia pseudoacacia

10.1021/np9002838Journal of Natural Products72111980-1987JNPR

Towards a global paradigm for research in early childhood education

Early years education is now a global activity, as school systems expand and diverse programmes become established in countries throughout the world. We inherit a rich legacy of theories, methodologies and evidence, from the vision of early childhood pioneers to the latest empirical research. I want to step back from particular initiatives and research evaluations to consider the underlying images of the child that inform early childhood research and practice. What would be an appropriate child development paradigm for promoting quality early years education in a global context? I question the adequacy of much theory and research to encompass global childhoods, especially the dangers inherent in current knowledge-imbalances. I ask about the way child development is conceptualised within early childhood work, and the potential of a sociocultural perspective. Finally, I ask about the status of young children themselves within early education research and practice; whether they are viewed as subjects in a child development project, as participants in a process or as consumers of a service. For each theme, I will argue that we are witnessing a paradigm shift which takes us beyond idealisations about normal development, children's nature and their needs. An alternative paradigm emphasises the plurality of pathways through childhood, the respects in which early development and education is a sociocultural process, and the status of children as active participants, with their own perspective on issues in their lives