Bacteria-Ridden Stethoscopes Abound in Hospitals


Stethoscopes used in an intensive care unit (ICU) are loaded with bacteria, including those that may be associated with hospital-acquired infections (HAIs), new data show. Moreover, standard cleaning methods did not eliminate the problems.

“Practitioner stethoscopes are contaminated by a plethora of bacteria, including organisms that may be associated with nosocomial infections. Cleaning reduces contamination but does not bring the bacterial biomass down to the level of clean stethoscopes nor does it significantly change the overall community composition. Thus, stethoscopes are a potential vector of HAI transfer,” the researchers write.

The study by Vincent R. Knecht, BS, from the Division of Pulmonary, Allergy and Critical Care, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, and colleagues was published online December 12 in Infection Control and Hospital Epidemiology.

“It is well documented that practitioner stethoscopes are not routinely disinfected, and studies based on bacterial culture show that they may be contaminated with potential pathogens including methicillin-resistant and
-sensitive Staphylococcus spp, multidrug-resistant P. aeruginosa, Acinetobacter spp, Enterococcus spp, Escherichia coli, Klebsiella spp, and Streptococcus spp…. Culture-based studies are limited, however, because culture can only identify agents of a priori interest but not entire microbial communities that may be present,” the researchers explain.

Therefore, the researchers used bacterial 16S ribosomal RNA gene sequencing to gain “unbiased profiling of entire bacterial communities” present on stethoscopes used in a medical ICU.

In the first set of stethoscopes (set A), they tested 20 stethoscopes carried by practitioners (physicians, nurses, and respiratory therapists), 20 individual-use patient-room stethoscopes, and 20 clean unused individual-use stethoscopes. In a second set (set B), the researchers tested 10 practitioner stethoscopes that were sampled before and after standardized cleaning (wiping vigorously with a hydrogen peroxide wipe for 60 seconds and left to dry).

Set C contained an additional 20 practitioner stethoscopes that were sampled before and after cleaning by the practitioner using the practitioner’s usual method of cleaning. Practitioners used hydrogen peroxide wipes (n = 14), alcohol swabs (70% isopropyl alcohol; n = 3), or bleach wipes (n = 3) to clean their stethoscopes and followed their personal preference regarding duration of cleaning.

The researchers found that all stethoscopes used in the ICU were significantly contaminated with a variety of pathogens. The highest bacterial contamination levels were found on practitioner stethoscopes, followed by patient-room stethoscopes. Bacterial contamination levels on clean stethoscopes and background controls were indistinguishable from each other.

Table. Potential Nosocomial Pathogens on Practitioner Stethoscopes

Set A (n = 20) Set C (n = 20, before cleaning)
Organism Frequency, No. (%) Frequency, No. (%)
Staphylococcus spp 20 (100) 20 (100)
S aureus 11 (55) 13 (65)
Pseudomonas spp 16 (80) 20 (100)
Acinetobacter spp 13 (65) 20 (100)
Clostridium spp 8 (40) 12 (60)
Enterococcus spp 8 (40) 18 (90)
Stenotrophomonas spp 7 (35) 18 (90)
Burkholderia spp 3 (15) 3 (15)

 

Staphylococcus spp were present on all stethoscopes; the investigators were able to determine the species on some of those, and more than half were contaminated with Staphylococcus aureus, even after practitioner cleaning.

“Both cleaning methods resulted in a significant reduction in bacterial contamination regardless of cleaning method,” the authors write. “In the standardized cleaning group, 5 of 10 stethoscopes fell below the level of the clean stethoscopes…. In the practitioner-preferred cleaning group, 2 of 10 stethoscopes fell below the level of clean stethoscopes.”

“This study underscores the importance of adhering to rigorous infection control procedures, including fully adhering to CDC [Centers for Disease Control and Prevention]–recommended decontamination procedures between patients, or using single-patient-use stethoscopes kept in each patient’s room,” senior author Ronald Collman, MD, a professor of medicine and pulmonary, allergy and critical care at the University of Pennsylvania Perelman School of Medicine, Philadelphia, said in a news release.

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Why it’s time for brain science to ditch the ‘Venus and Mars’ cliche.


Reports trumpeting basic differences between male and female brains are biological determinism at its most trivial, says the science writer of the year
brains illustration male female

There is little evidence to suggest differences between male and female brains are caused by anything other than cultural factors. Photograph: Alamy

As hardy perennials go, there is little to beat that science hacks’ favourite: the hard-wiring of male and female brains. For more than 30 years, I have seen a stream of tales about gender differences in brain structure under headlines that assure me that from birth men are innately more rational and better at map-reading than women, who are emotional, empathetic multi-taskers, useless at telling jokes. I am from Mars, apparently, while the ladies in my life are from Venus.

And there are no signs that this flow is drying up, with last week witnessing publication of a particularly lurid example of the genre. Writing in the US journal Proceedings of the National Academy of Sciences, researchers at the University of Pennsylvania in Philadelphia revealed they had used a technique called diffusion tensor imaging to show that the neurons in men’s brains are connected to each other in a very different way from neurons in women’s brains.

This point was even illustrated by the team, led by Professor Ragini Verma, with a helpful diagram. A male brain was depicted with its main connections – coloured blue, needless to say – running from the front to the back. Connections within cranial hemispheres were strong, but connections between the two hemispheres were weak. By contrast, the female brain had thick connections running from side to side with strong links between the two hemispheres.

Men and women brains U.Penn studyA photo issued by University of Pennsylvania researchers showing intra-hemispheric connections (blue) and inter- hemispheric connections (orange) in men’s and women’s brains. Male top row, female bottom row. Photograph: National Academy Of Sciences/PA”These maps show us a stark difference in the architecture of the human brain that helps provide a potential neural basis as to why men excel at certain tasks and women at others,” said Verma.

The response of the press was predictable. Once again scientists had “proved” that from birth men have brains which are hardwired to give us better spatial skills, to leave us bereft of empathy for others, and to make us run, like mascara, at the first hint of emotion. Equally, the team had provided an explanation for the “fact” that women cannot use corkscrews or park cars but can remember names and faces better than males. It is all written in our neurons at birth.

As I have said, I have read this sort of thing before. I didn’t believe it then and I don’t believe it now. It is biological determinism at its silly, trivial worst. Yes, men and women probably do have differently wired brains, but there is little convincing evidence to suggest these variations are caused by anything other than cultural factors. Males develop improved spatial skills not because of an innate superiority but because they are expected and encouraged to be strong at sport, which requires expertise at catching and throwing. Similarly, it is anticipated that girls will be more emotional and talkative, and so their verbal skills are emphasised by teachers and parents. As the years pass, these different lifestyles produce variations in brain wiring – which is a lot more plastic than most biological determinists realise. This possibility was simply not addressed by Verma and her team.

Equally, when gender differences are uncovered by researchers they are frequently found to be trivial, a point made by Robert Plomin, a professor of behavioural genetics at London’s Institute of Psychiatry, whose studies have found that a mere 3% of the variation in young children’s verbal development is due to their gender. “If you map the distribution of scores for verbal skills of boys and of girls, you get two graphs that overlap so much you would need a very fine pencil indeed to show the difference between them. Yet people ignore this huge similarity between boys and girls and instead exaggerate wildly the tiny difference between them. It drives me wild.”

I should make it clear that Plomin made that remark three years ago when I last wrote about the issue of gender and brain wiring. It was not my first incursion, I should stress. Indeed, I have returned to the subject – which is an intriguing, important one – on a number of occasions over the years as neurological studies have been hyped in the media, often by the scientists who carried them out. It has taken a great deal of effort by other researchers to put the issue in proper perspective.

A major problem is the lack of consistent work in the field, a point stressed to me in 2005 – during an earlier outbreak of brain-gender difference stories – by Professor Steve Jones, a geneticist at University College London, and author of Y: The Descent of Men. “Researching my book, I discovered there was no consensus at all about the science [of gender and brain structure],” he told me. “There were studies that said completely contradictory things about male and female brains. That means you can pick whatever study you like and build a thesis around it. The whole field is like that. It is very subjective. That doesn’t mean there are no differences between the brains of the sexes, but we should take care not to exaggerate them.”

Needless to say that is not what has happened over the years. Indeed, this has become a topic whose coverage has been typified mainly by flaky claims, wild hyperbole and sexism. It is all very depressing. The question is: why has this happened? Why is there such divergence in explanations for the differences in mental abilities that we observe in men and women? And why do so many people want to exaggerate them so badly?

The first issue is the easier to answer. The field suffers because it is bedevilled by its extraordinary complexity. The human brain is a vast, convoluted edifice and scientists are only now beginning to develop adequate tools to explore it. The use of diffusion tensor imaging by Verma’s team was an important breakthrough, it should be noted. The trouble is, once more, those involved were rash in their interpretations of their own work.

“This study contains some important data but it has been badly overhyped and the authors must take some of the blame,” says Professor Dorothy Bishop, of Oxford University. “They talk as if there is a typical male and a typical female brain – they even provide a diagram – but they ignore the fact that there is a great deal of variation within the sexes in terms of brain structure. You simply cannot say there is a male brain and a female brain.”

Even more critical is Marco Catani, of London’s Institute of Psychiatry. “The study’s main conclusions about possible cognitive differences between males and females are not supported by the findings of the study. A link between anatomical differences and cognitive functions should be demonstrated and the authors have not done so. They simply have no idea of how these differences in anatomy translate into cognitive attitudes. So the main conclusion of the study is purely speculative.”

The study is also unclear how differences in brain architecture between the sexes arose in the first place, a point raised by Michael Bloomfield of the MRC’s Clinical Science Centre. “An obvious possibility is that male hormones like testosterone and female hormones like oestrogen have different effects on the brain. A more subtle possibility is that bringing a child up in a particular gender could affect how our brains are wired.”

In fact, Verma’s results showed that the neuronal connectivity differences between the sexes increased with the age of her subjects. Such a finding is entirely consistent with the idea that cultural factors are driving changes in the brain’s wiring. The longer we live, the more our intellectual biases are exaggerated and intensified by our culture, with cumulative effects on our neurons. In other words, the intellectual differences we observe between the sexes are not the result of different genetic birthrights but are a consequence of what we expect a boy or a girl to be.

Why so many people should be so desperate to ignore or obscure this fact is a very different issue. In the end, I suspect it depends on whether you believe our fates are sealed at birth or if you think that it is a key part of human nature to be able to display a plasticity in behaviour and in ways of thinking in the face of altered circumstance. My money is very much on the latter.

WHAT THE NEW STUDY SHOWS

In their study, Verma and her colleagues, investigated the gender differences in brain connectivity in 949 individuals – 521 females and 428 males – aged between eight and 22 years. The technique they used is known as diffusion tensor imaging (DTI), a water-based imaging technology that can trace and highlight the fibre pathways that connect the different regions of the brain, laying the foundation for a structural connectome or network of the whole brain. These studies revealed a typical pattern, claim Verma and her team: men had stronger links between neurons within their cranial hemispheres while women had stronger links between the two hemispheres, a difference that the scientists claimed was crucial in explaining difference in the behaviour of men and women.

But the technique has been criticised. “DTI provides only indirect measures of structural connectivity and is, therefore, different from the well validated microscopic techniques that show the real anatomy of axonal connections,” says Marco Catani, of London’s Institute of Psychiatry. “Images of the brain derived from diffusion tensor MRI should not be equated to real connections and results should always be interpreted with extreme caution.”This point is backed by Prof Heidi Johansen-Berg, of Oxford University, who attacked the idea that brain connections should be considered as hard-wired. “Connections can change throughout life, in response to experience and learning. As far as I can tell, the authors have not directly related these differences in brain connections to differences in behaviour. It is a huge leap to extrapolate from anatomical differences to try to explain behavioural variation between the sexes. The brain regions that have been highlighted are involved in many different functions.”

 

Sarah Murnaghan gets lung transplant.


lung

A severely ill 10-year-old girl to whom a US judge granted a prime spot on the adult transplant list despite her youth has received a new set of lungs.

Sarah Murnaghan’s family said they were “thrilled” the six-hour surgery to implant adult lungs went smoothly and that she had done “extremely well”.

The family had challenged a US policy relegating under-12s to the bottom of the adult organ donation list.

Analysts have warned the judge’s decision set a dangerous precedent.

The Obama administration declined to intervene in Sarah’s case, arguing transplant policy should be made by doctors and scientists rather than the government.

Children under 12 have priority for paediatric lung donations, but far fewer paediatric lungs are donated than adult lungs.

‘Close to the end’

Sarah’s surgery began around 11:00 local time (15:00 GMT) on Wednesday in Philadelphia.

“Her doctors are very pleased with both her progress during the procedure and her prognosis for recovery,” the family said in a statement about seven hours later.

Her aunt Sharon Ruddock told reporters the lungs had been resized to fit her small body, but her recovery time would probably be extensive because the girl had been unconscious and breathing through a tube since Saturday as her condition deteriorated.

Complications from lung transplants can include rejection of the new lungs and infection.

 “Start Quote

It’s important that people understand that money, visibility, being photogenic… are factors that have to be kept to a minimum”

Dr Arthur Caplan,Bioethicist

Since Sarah’s case came to light, the national organisation that sets organ transplant policy has created a special appeal and review system for young patients.

About 30 children under the age of 11 are on the waiting list for a lung transplant, according to the Organ Procurement and Transplantation Network, out of a total of 1,650 potential lung recipients.

Last week, US District Judge Michael Baylson, who is independent of the Obama administration, ruled Sarah and another child at Children’s Hospital in Philadelphia, 11-year-old Javier Acosta, eligible for a better spot on the adult list.

He found that the US policy amounted to improper age discrimination.

Both children suffer from with cystic fibrosis, a chronic lung disease. Sarah’s condition had worsened significantly in the last 18 months, diminishing her lung capacity to 30%.

Last month she was admitted to the intensive care unit in hospital. Doctors told the Murnaghans that if Sarah were an adult, she would probably be at “the very top” of the lung transplant list.

Ms Ruddock said she was sure that had Sarah not been put on the adult list, “we would have lost her”.

“She was very close to the end,” she said.

US patients on organ waiting lists as of 12 June 2013

  • Kidney: 96,555
  • Pancreas: 1,180
  • Kidney/Pancreas: 2,089
  • Liver: 15,736
  • Intestine: 264
  • Heart: 3,506
  • Lung: 1,650
  • Heart/Lung: 46

Source: Organ Procurement and Transplantation Network

Some analysts warned the intervention of politicians and judges in the cases would set a dangerous precedent.

Dr Arthur Caplan, a bioethicist at New York University Langone Medical Center, said children fared worse than adults after lung transplants, one of the reasons for the existing policy.

“In general, the road to a transplant is still to let the system decide who will do best with scarce, lifesaving organs,” Dr Caplan said.

“And it’s important that people understand that money, visibility, being photogenic… are factors that have to be kept to a minimum if we’re going to get the best use out of the scarce supply of donated cadaver organs.”

Before Sarah, only one lung transplant from a donor older than 18 to a recipient younger than 12 had taken place in the US since 2007, according to US government data.

Source: BBC

Prostate Cancer Risk Linked To Early-Onset Baldness In New Study.


African american shaved head

French researchers said it, and now a team from the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania in Philadelphia have released new evidence to support their claim: Men who lose their hair early in life have a greater risk of developing prostate cancer.

In a study of 537 African-American men — 318 with prostate cancer and 219 controls — investigators discovered that baldness of any kind was associated with a 69 percent increased risk of prostate cancer, particularly among African-American men.

According to the study, which was published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, black men with frontal baldness, and not vertex baldness, were more than twice as likely to have been diagnosed with advanced prostate cancer. The association was even stronger among those who were diagnosed when younger than 60, with a sixfold increase in high-stage prostate cancer and a fourfold increase in high-grade prostate cancer.

The findings concur with a 2011 report showing that men who start to go bald at age 20 may be more likely to develop prostate cancer in later life. Though grim, the team conducting that study suggested that their findings be used as a basis for early screening or preventative therapy for those at higher risk.

“Early-onset baldness may be a risk factor for early-onset prostate cancer in African-American men, particularly younger men,” said Charnita Zeigler-Johnson, Ph.D., research assistant professor at the Center for Clinical Epidemiology and Biostatistics at UPenn and lead author of the study. “Pending future studies to confirm our results, there is a potential to use early-onset baldness as a clinical indicator of increased risk for prostate cancer in some populations of men,” he added.

Black men have the highest incidence rate for prostate cancer in the United States and are more than twice as likely as White men to die of the disease, according to the National Cancer Institute.

 

Subclinical hyperthyroidism unrelated to overall, CV mortality.


The associated health risks for subclinical hyperthyroidism in patients aged at least 65 years are not entirely clear. However, data presented at the 82nd Annual Meeting of the American Thyroid Association suggest that the disease was not linked to overall or cardiovascular mortality.

“[Older patients with subclinical hypothyroidism] They are a group with a high prevalence of subclinical thyroid dysfunction and a high prevalence of comorbidities that make their management more complex,” researcher Anne R. Cappola, MD, ScM, associate professor of medicine at Penn Medicine and physician at the Perelman Center for Advanced Medicine in Philadelphia told Endocrine Today.

Cappola said there are two clinical implications.

“One, thyroid function testing should be repeated in older people with subclinical hyperthyroidism to confirm testing prior to initiating management. Two, older people with subclinical hyperthyroidism are at increased risk of atrial fibrillation,” Cappola said.

The Cardiovascular Health Study (CHS) was used to examine the 5,009 community-dwelling patients aged 65 years and older who were not taking thyroid medications. According to data, the serum thyroid-stimulating hormone and free thyroxine concentrations were measured in banked specimens at visits between 1989 and 1990, 1992 and 1993, and 1996 and 1997.

Within the CHS, researchers identified 70 patients with an average age of 73.7 years (60% women, 24% not white) with subclinical hyperthyroidism based on their first TSH measurement. They studied the persistence, resolution and progression of the disease during a 2- to 3-year period.

Using Cox proportional hazard models, researchers were able to determine the link between subclinical hyperthyroidism and CV risk and total mortality after more than 10 years of follow-up, with 4,194 euthyroid patients used as a reference group.

According to data, of the patients with subclinical hyperthyroidism who participated in follow-up thyroid testing or were taking thyroid medication at the time of follow-up (n=44), 43% persisted; 41% became euthyroid; 5% progressed to the point of overt hyperthyroidism; and 11% began taking thyroid medication.

“Our study provides additional supportive data in both estimates of persistence of subclinical hyperthyroidism and risk of cardiovascular effects,” Cappola said.

  • Source: Endocrine Today.

 

 

 

 

 

FDA Approves New Drug to Treat Chronic Myelogenous Leukemia.


The Food and Drug Administration has approved bosutinib (Bosulif) to treat chronic myelogenous leukemia (CML), a blood and bone marrow disease that usually affects older adults. Bosutinib is intended for patients with chronic, accelerated, or blast phase Philadelphia chromosome-positive CML who are resistant to or who cannot tolerate other therapies, including imatinib (Gleevec).

Most people with CML have a chromosomal aberration called the Philadelphia chromosome, which causes the bone marrow to make an abnormal tyrosine kinase enzyme called Bcr-Abl. This enzyme promotes the proliferation of abnormal and unhealthy infection-fighting white blood cells called granulocytes. Bosutinib is a tyrosine kinase inhibitor (TKI) that works by blocking Bcr-Abl signaling.

Bosutinib’s safety and effectiveness were evaluated in a clinical trial involving 546 adults with chronic, accelerated, or blast phase CML. All of the patients had been previously treated with at least one TKI, either imatinib or imatinib followed by dasatinib (Sprycel) and/or nilotinib (Tasigna).

Among patients with chronic phase CML, 34 percent of patients who had been treated previously with imatinib and 27 percent of those who received more than one prior TKI achieved a major cytogenetic response within 24 weeks.

Among patients with accelerated phase CML who had received at least one prior TKI, 30 percent had their blood counts return to the normal range (a complete hematologic response) by week 48, and 55 percent achieved a complete hematologic response, no evidence of leukemia, or return to chronic phase (an overall hematologic response) by week 48. Among patients with blast phase CML who had received at least one prior TKI, 15 percent had a complete hematologic response and 28 percent an overall hematologic response by week 48.

The most common side effects observed in those receiving bosutinib were diarrhea, nausea, a low level of platelets in the blood, vomiting, abdominal pain, rash, anemia, fever, and fatigue.

Source: NCI

 

Genome Study Points to Treatments for High-Risk Form of Childhood Leukemia.


Using genomic tools, researchers have uncovered genetic changes associated with a form of leukemia that recurs in some children. The findings, reported last month in Cancer Cell, suggest that some of these young patients may benefit from targeted drugs that are available but currently not used to treat this particular form of the disease.

The study focused on a subtype of acute lymphoblastic leukemia (ALL) known as Philadelphia chromosome-like ALL. Children with this subtype have a higher risk of a recurrence after standard chemotherapy and lower rates of long-term survival than other children with high-risk ALL.

Since the subtype was first described in 2009 (here and here), researchers have identified genetic changes that could explain about half of these cases. Building on this work, a team led by Dr. Charles Mullighan of the St. Jude Children’s Research Hospital analyzed RNA from 15 patients with the subtype and sequenced the genomes of two of these patients.

The results, Dr. Mullighan said, were “striking.” His team found a diverse set of genetic abnormalities linked to cancer, including DNA mutations and chromosomal rearrangements. The biological effects of these changes, however, appeared to be concentrated primarily on two signaling pathways involved in cell growth and proliferation.

Making Use of Available Drugs 

“We found a wide range of gene fusions, but they converged on a limited number of pathways,” said Dr. Kathryn Roberts of St. Jude, a study author. These pathways included the proteins ABL1, PDGFRB, and JAK2, which all play a role in cell growth.

In the lab, several drugs that inhibit growth-promoting signals through these pathways—including imatinib (Gleevec), dasatinib (Sprycel), and ruxolitinib (Jakafi)—showed anticancer effects against models of Philadelphia chromosome-like ALL.

“These findings are important because these children frequently have very poor outcomes,” Dr. Mullighan said. Future studies could test whether patients with mutations affecting these pathways could be candidates to receive targeted drugs along with chemotherapy, he added.

Overall, children with high-risk ALL have a greater than 80 percent chance of being cured by standard treatments, but only about 60 percent of children with Philadelphia chromosome-like ALL are alive and free of cancer after 5 years. This subtype, which accounts for about 15 percent of childhood ALL cases, shows similar patterns of gene activity as Philadelphia chromosome-positive ALL, but the BCR-ABL1 fusion gene is absent.

Better Diagnostic Tests Needed

The new results are from the TARGET initiative, an NCI-supported project that brings together experts on childhood cancers and genome analysis to identify genetic alterations that could be targeted by new or existing therapies.

“These are exactly the kind of results this initiative was created to generate,” said Dr. Malcolm Smith of NCI’s Cancer Therapy Evaluation Program and an NCI leader of the TARGET initiative.

“At this point there are anecdotal examples of how these findings could be translated for broader application,” Dr. Smith continued. Future challenges include improving diagnostic tests to detect the specific molecular alterations and developing treatments appropriate for each alteration, he noted.

At St. Jude, Dr. Roberts is investigating two approaches for detecting this subtype of ALL at the time of diagnosis. One strategy is to profile the active pathways in the leukemia cells, and the other is to look for signature patterns of gene activity.

These tests could serve as an initial screen for Philadelphia chromosome-like ALL, followed by testing for specific genetic alterations associated with the disease, according to Dr. Christine Harrison of Newcastle University in the United Kingdom, who wrote an accompanying editorial.

She praised the study for providing “a comprehensive genomic definition” of Philadelphia chromosome-like ALL, showing it to be a disease with distinctive genetic alterations that affect a range of proteins involved in cell growth.

The work also illustrates one way that cancer researchers are increasingly using genomic tools, noted co-author Dr. Stephen Hunger of the University of Colorado, who is also chair of the Children’s Oncology Group ALL Disease Committee.

“The first step is to identify the abnormalities driving the development of a particular cancer,” he explained. “Then, you use therapies directed against those abnormalities—either alone or with chemotherapy—to improve the outcomes of patients with the least possible side effects.”

Dr. Smith added, “Targeted agents are already known for some of the molecular alterations in Philadelphia chromosome-like ALL, but for others they will need to be identified.”

Dr. Mullighan agreed that a more complete understanding of the Philadelphia chromosome-like ALL subtype is needed. When his team expanded their analysis to include samples from more than 400 patients, the critical lesions in about 20 percent of the cases were unknown.

“We need to know what the changes are, and no single method of analysis is going to pick up every genetic alteration,” he said.

Knowledge gained from studying Philadelphia chromosome-like ALL in children could prove useful for adolescents and young adults as well. This subtype is thought to be more common with advancing age, and the prognosis may also worsen with age.

Since the study was published, Dr. Mullighan has received inquiries from doctors who want to know whether their patients with ALL might be candidates for the new approach. For the study authors, this has underscored the importance of developing clinically accredited tests.

“We really need to develop the diagnostic tests so that we can identify these patients at the time of diagnosis and direct them to the most appropriate targeted therapy,” Dr. Roberts said.

Source: NCI.