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“One of the Most Fascinating Stories in the History of Medicine”

15 Sep, 15 | by BMJ Clinical Evidence

By Nóirín O’Neill  Noirin O'Neill

The history of Acute Promyelocytic Leukaemia (APL) is one of the most fascinating stories in the history of medicine.” Dr Francesco Lo-Coco, Professor of Haematology.

APL is a rare form of leukaemia that affects one in a million people in Europe. Dr Leaft Hillestad first described APL in 1957. Dr Hillestad identified APL as a distinctive subtype of AML and one that is aggressive and rapidly fatal if not correctly diagnosed and treated immediately. Morphologically, it is identified as the M3 subtype of acute myeloid leukemia by the French-American-British classification and cytogenetically is characterised by a balanced reciprocal translocation between chromosomes 15 and 17, which results in the fusion between promyelocytic leukaemia (PML) gene and retinoic acid receptor α (RARα). Further research was carried out by French and American scientists into the disease but it was Chinese doctors (Dr Zhen-yi Wang, Dr Zhu Chen) who made the revolutionary discovery that APL was responsive to all trans-retinoic acid (ATRA), a Vitamin A derivative. The drug ATRA causes leukaemic cells to abandon their relentless growth and mature into white blood cells. ATRA makes the leukemic cells “behave”. APL was transformed from a highly fatal disease to a highly curable disease. Dr Zhen-yi Wang’s group introduced ATRA in treating APL in 1985, and APL patients like me have benefited from his achievement. more…

Evidence-Based Practice in Nursing in 2015: The Challenges

30 Apr, 15 | by BMJ Clinical Evidence

Alison Twycrossby Alison Twycross

I have been editor of Evidence-Based Nursing for the past five years.

Earlier this month I presented a paper at Evidence Live 2015 reflecting on my views about the challenges for evidence-based nursing in 2015. This Blog is a summary of that paper. more…

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