In general the authors presented an interesting

In general, the authors presented an interesting nanoparticle formulation for the radiosensitization of BPL. The animal studies proved that C61-liposome+TBI is a promising treatment strategy to overcome BPL relapse. Disclosure
Acute myeloid leukaemia (AML) is a heterogeneous clonal disorder arising in the myeloid lineage with an average age of around 62years at diagnosis. Morphological and cytogenetic analysis has identified a number of sub-types with a wide range of survival outcomes. Some of the more favourable outcomes are associated with patients who harbour balanced reciprocal chromosomal translocations including the t(15;17) translocation resulting in a fusion gene between PML and RARα; this group of patients have acute promyelocytic leukaemia (APL) (). Over the past few years, next-generation sequencing has assisted in the identification of a spectrum of molecular mutations in many of the other sub-types of AML, particularly in those with an apparent normal karyotype. Clinical trials have shown that patients with t(15;17) respond very well to All-Trans-Retinoic-Acid (ATRA) or to ATRA with arsenic trioxide (ATO) resulting in some excellent outcomes in which there is an 85–90% 5-year overall survival (). ATRA has been widely used in the treatment of APL due to its ability to specifically bind to the ligand-binding domain of the RARα portion of the fusion protein, resulting in the terminal differentiation and subsequent apoptosis of the leukaemic promyelocytes. ATO which targets the PML portion has been combined with conventional ATRA therapy resulting in degradation of the fusion protein. Furthermore, with this therapeutic combination, chemotherapy could be omitted for the patients who have low risk APL ().
Chronic lymphocytic leukaemia (CLL) is the most common adult leukaemia in the Western world and is characterized by the accumulation of CD5+/CD19+/CD23+ mature Gefitinib in the peripheral blood, bone marrow and lymphoid tissue of patients. Despite major improvements in therapy over the past decades, CLL remains essentially an incurable disease. The clinical course of CLL is highly variable with life expectancies running from months to decades. The presence of recurrent chromosomal aberrations along with the mutation status of genes in the tumour cells of CLL patients are the current gold standards of clinical prognostication. However, these tests are laborious to implement and require techniques not readily available in all diagnostic laboratories. In this issue of , Ferrajoli and colleagues propose that plasma and tumour cell-derived microRNAs (miRNAs) encoded by Esptein–Barr virus (EBV), the causative agent of infectious mononucleosis (also known as ), could be useful diagnostic and prognostic biomarkers for this disease (). Plasma biomarkers are an appealing prospect for clinical practice as the ability to directly measure molecules in the blood of CLL patients (or other types of cancer) without needing to purify tumour cells would almost certainly lead lower costs and shorten turnaround times for patients. The presence of nucleic acids (DNA) in the blood was first demonstrated over 60years ago (), although their potential as a non-invasive biomarker of cancer was not recognised until some years later. It was however the 2008 discovery of microRNAs (miRNAs) in the blood of cancer patients () that has put the field in the spotlight and there are now more than 4500 publications on the subject (). MiRNAs are particularly attractive candidates as non-invasive biomarkers as they are able to sub-classify cancers to a greater degree of accuracy than traditional gene expression analysis (), and are protected from the high levels of RNase activity present in blood (). Furthermore, unlike protein biomarkers which can persist in the blood for many weeks, the short half-life of circulating RNA makes it eminently suitable as a tool to monitor the evolution of a cancer in real-time allowing treatment decisions to be taken much more efficiently. Despite its promise, the study of circulating miRNA is very much in its infancy reflected in the many non-overlapping and even contradictory studies have been published. On many occasions this disparity is due to technical factors particularly variability in the choice of starting material ( exosomes, sera or plasma), purification techniques, detection platforms and/or statistical methodologies. Perhaps the most serious barrier to translation of these findings into the clinic is the low number of patients typically used for these studies. To their credit the study by Ferrajoli et al. not only studied a high number of CLL patient samples (n=516) with separate test and validation cohorts, but also used three different platform technologies to detect miRNAs. Moreover, they measured expression variability of candidate reference genes in the samples. This often overlooked consideration is crucial for the reliability of miRNA detection in blood as expression levels of the most commonly used reference miRNAs can vary significantly amongst samples depending upon the pathology studied (). In the present study they found that levels of the EBV-miRNA BHRF1-1 were significantly higher in plasma samples from CLL patients than healthy individuals, and that patients with higher levels also had high B2M and higher Rai stage, both indicators of more advanced disease.