| 0:00:00 | my name aside can vary and i'm a felon he mythology and an ecology at |
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| 0:00:04 | the man clinical rochester |
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| 0:00:06 | and then assistant professor of madison |
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| 0:00:09 | and quality of the male clinic college of madison |
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| 0:00:12 | i'll be discussing a recent paper entitled at you can for plastic leukaemia and adolescents |
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| 0:00:17 | and young adults from genomics to the clinics |
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| 0:00:21 | the seen your author of this paper is doctor marked with so |
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| 0:00:25 | you'd look for plastic looking man and all sensing younger adults |
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| 0:00:28 | represents a unique and challenging disease and data for multiple reasons |
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| 0:00:33 | this by there is an improvement in survival in this population |
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| 0:00:37 | is still lagging behind compared to the excellent your rates in paediatric a well |
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| 0:00:43 | a reason analysis of this year database |
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| 0:00:46 | sure that the five year survival in this population was only sixty three percent compared |
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| 0:00:51 | to eighty seven percent in children up to fifteen years of age |
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| 0:00:55 | the reasons for this significant difference in survival are complex and not fully understood |
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| 0:01:02 | there are substantial differences in disease biology response to chemotherapy |
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| 0:01:07 | role of religion extends all transplantation |
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| 0:01:11 | and novel therapy you know this group |
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| 0:01:15 | several biological differences between paediatric i l and l and adolescents and young adults have |
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| 0:01:21 | been described |
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| 0:01:23 | first of all |
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| 0:01:24 | genetic alterations associated with good prognosis |
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| 0:01:29 | so it's just for hyper deplore d and trance location twelve twenty one |
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| 0:01:34 | bikinis in frequency with age well tourist site again ticks increasing prevalence |
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| 0:01:40 | in addition to that even good risk side the genetics such as type are deployed |
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| 0:01:45 | be |
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| 0:01:46 | are associated with inferior outcomes |
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| 0:01:48 | and adolescents and young adults compared to their counterpart in children |
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| 0:01:55 | patients between fifteen and thirty years of age have higher rates |
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| 0:02:00 | of |
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| 0:02:01 | minimal residual disease burden after chemotherapy compared to children |
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| 0:02:09 | there is also higher incidence of |
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| 0:02:12 | early precursor t cell a low |
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| 0:02:15 | and adolescents and young adults |
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| 0:02:17 | which is generally defined and eighty characterized by inferior outcomes and poor response to chemotherapy |
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| 0:02:24 | several studies have reported the genomic profiling and bit in paediatric patients with a well |
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| 0:02:31 | well no focus genomic analysis of idle sensing younger adults has been performed |
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| 0:02:36 | these patients what are frequently included in paediatric studies |
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| 0:02:41 | their genetic profile was similar to patients with high risk a l |
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| 0:02:47 | for example |
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| 0:02:48 | jack mediation |
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| 0:02:49 | intra chromosome amplification of chromosome twenty one |
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| 0:02:54 | and b c r a b a like a level where frequent findings |
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| 0:03:00 | in addition to the difference in biology |
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| 0:03:03 | between paediatric a allow and l and adolescents and young adults |
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| 0:03:08 | several analyses have shown survival benefits |
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| 0:03:11 | when these patients are treated on paediatric intense compared to adult protocols |
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| 0:03:17 | the reasons for this are not clear and likely to be mode a factorial |
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| 0:03:22 | including |
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| 0:03:23 | earlier introduction of c n as direct if the wrapping paediatric protocols |
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| 0:03:28 | the use of more intense chemotherapy |
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| 0:03:31 | and higher rates of compliance one adolescents are treated on paediatric protocols under the parents |
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| 0:03:37 | supervision |
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| 0:03:39 | the role of a logit mixed them so transplantation and adolescents and young adults with |
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| 0:03:44 | a l is also controversial |
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| 0:03:48 | there have been a prospective trials addressing this group |
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| 0:03:52 | and subgroup analyses |
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| 0:03:54 | from a little transplant trials have been controversial |
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| 0:03:58 | and finally with the emergence of novel therapies and at all day l |
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| 0:04:04 | i dollar sense and younger adults |
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| 0:04:05 | are frequently included |
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| 0:04:08 | in this clinical trials |
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| 0:04:10 | they seem to experience benefit from such approaches |
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| 0:04:14 | for example they benefited the most from a high degree talks a madman a pretty |
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| 0:04:18 | be al |
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| 0:04:20 | in early study is |
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| 0:04:22 | in a two zone a poser got my as in |
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| 0:04:24 | cluster opinion and their libyan |
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| 0:04:27 | have also want to have activity |
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| 0:04:30 | in early clinical trials and adolescents and young adult |
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