Much progress has been made during the last few decades in the treatment of hematological malignancies. Monoclonal antibodies (MoAbs) represent a major advance toward a targeted therapy that can dramatically improve the antitumor effect with a substantial reduction of toxicity derived from therapy. Unlike many small molecules, MoAbs offer unique target specificity. Several MoAbs are now in clinical use for hematologic malignancies therapy, and many others are currently undergoing clinical evaluation. This review summarizes the state-of-the-art MoAbs treatment, beginning with an overview of the scientific background to their synthesis, mechanism of action and choice of target antigen, mainly focusing on those antibodies that are currently in use in clinical practice. Despite these advances, significant challenges remain in the identification of optimal cellular targets, antibody forms and treatment schedules for therapeutic applications.

L’utilisation des médecines alternatives et complémentaires (MAC) est très fréquente chez les patients cancéreux. Les objectifs de cette étude sont d’analyser la fréquence et les raisons d’utilisation des MAC chez 400 patients traités dans un service d’oncologie au Maroc. Un questionnaire anonyme a été proposé aux patients en cours de traitement. Sur les 384 questionnaires analysables, 71 % des patients utilisent les MAC. La méthode la plus utilisée est la thérapie spirituelle (60 %) et l’utilisation des plantes médicinales (36 %). Les raisons d’utilisation des MAC sont de réduire la souffrance morale dans 53 % des cas et d’augmenter l’immunité dans 32 % des cas. Les effets indésirables de ces thérapies sont reportés dans 2 % des cas. Seulement 5 % des malades ont discuté des MAC avec leur médecin. Le coût des MAC est de moins de 100 euros dans 88 % des cas. Une communication médecin-malade est nécessaire pour optimiser la prise en charge face à ces traitements dont l’efficacité demeure encore non prouvée. Use of complementary and alternative medicine (CAM) is very frequent in cancer patients. The aims of this study were to analyze the frequency, the reasons of use of CAM in patients with a cancer treated in a Moroccan oncology department. We included in this study 400 patients. An anonymous questionnaire was proposed to patients during treatment. Over 384 analyzable questionnaires, 71% of patients were using CAM. The most frequent method was religious therapy (60%). The second one was herbal medicine (36%). The main reason for using CAM was reducing psychic pain in 53%, and boosting the immune system in 32%. Adverse effects were reported in 2% of cases. Only 5% of patients discussed CAM with their doctors. The cost of CAM was less than 100 Euros in 88% of cases. To optimize the patient-physician relationship and to avoid a propensity to unproved treatments, accurate and adequate communication is necessary.

All-trans retinoic acid (ATRA) induces complete remission in most cases of acute promyelocytic leukemia. Toxicity of ATRA has been shown to be mild, consisting of headache, dry skin, dermatitis, and gastrointestinal disorders. We describe a case of scrotal ulceration with ATRA use in a Moroccan patient, an occurrence that has been rarely reported in the medical literature. The pathogenesis of scrotal ulceration remains unknown. Our experience indicates the importance of recognizing genital ulcers associated with ATRA in order that appropriate countermeasures can be taken.

Introduction: Tumor lysis syndrome (TLS) is a serious complication of malignancies and can result in renal failure or death. Review: In tumors with a high proliferative rate with a relatively large mass and a high sensitivity to cytotoxic agents, the initiation of therapy often results in the rapid release of intracellular anions, cations and the metabolic products of proteins and nucleic acids into the bloodstream. The increased concentrations of uric acid, phosphates, potassium and urea can overwhelm the body’s homeostatic mechanisms to process and excrete these materials and result in the clinical spectrum associated with TLS. Typical clinical sequelae include gastrointestinal disturbances, neuromuscular effects, cardiovascular complications, acute renal failure and death. Tumor lysis syndrome can also compromise the efficacy or administration of curative therapies. Available evidence suggests that the incidence of clinical TLS is approximately 3–7% for acute leukemias and 4–11% for lymphomas. Pediatric cancers are the leading cause of death by disease in children. The most common pediatric cancers include the leukemias, lymphomas, central nervous system tumors and neuroblastoma. Thus, TLS is a major concern to practitioners caring for pediatric oncology patients. Given the complexity of TLS prevention and treatment, a multidisciplinary approach involving the collaboration of medical oncologists/ hematologists and nephrologists has the greatest potential of ensuring optimal patient outcomes. Rehydration is fundamental in the management of TLS in addition to the current standard therapy for hyperuricemia which include rasburicase and allopurinol. Conclusion: The early recognition and treatment of metabolic abnormalities often prevents the severe and life-threatening complications associated with tumor lysis syndrome. Keyswords: Acute Renal Failure; Burkitt’s Lymphoma; Hematologic Malignancies; Hydration; Tumor Lysis Syndrome