diagnostic strategies and treatment for ewing’s sarcoma尤文氏肉瘤的诊断和治疗策略.pdfVIP

International Journal of Clinical Medicine, 2012, 3, 538-543 / 10.4236/ijcm.2012.36097 Published Online November 2012 (http://www.SciRP.org/journal/ijcm) Diagnostic Strategies and Treatment for Ewing’s Sarcoma Roumiana Todorova1*, Atanas T. Atanasov2 1Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Sofia, Bulgaria; 2Department of Physics and Biophysics, Medical Faculty, Thracian University, Stara Zagora, Bulgaria. * Email: todorova@bio21.bas.bg, atanastod@abv.bg Received August 19th, 2012; revised September 22nd, 2012; accepted October 24th, 2012 ABSTRACT Ewing’s sarcoma is an enigmatic malignancy of progenitor cell origin, driven by transcription factor oncogenic fusions. About 85% of ESFT cases harbor the t(11;22) translocation and express the fusion protein EWS-FLI. Both bone marrow-derived human Mesenchymal stem cells and Neural crest stem cells are permissive for EWS-FLI1 expression that initiates transition to ESFT-like cellular phenotype. Diagnosis of Ewing’s tumor is based on pathologic and mo- lecular findings. The hypoxia enhances the malignancy of ESFT invasive capacity. An ALDHhigh subpopulation of Ew- ing’s sarcoma cells, capable of self-renewal, tumor initiation and resistant to chemotherapy in vitro, are not resistant to YK-4-279. Intensive high-dose chemotherapy followed by stem-cell reconstitution was used for ESFT patients in second remission. Plerixafor in combination with G-CSF is an effective enhance stem cell mobilization regimen for stem cell collection with lowest success rate in patients with neuroblastoma. The ESFT-derived antigens EZH2(666) and CHM1(319) are suitable targets for protective allo-restricted human CD8(+) T-cell responses against non-immu- nogenic ESFT. Primitive neuroectodermal features and MSC origin are both compatible with G(D2) aberrant expres- sion and explore G(D2) im