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Les hémopathies malignes constituent un groupe hétérogène de pathologies classées selon des critères clinico-biologiques comprenant entre autres la cytogénétique et la biologie moléculaire. La cytogénétique hématologique n'a cessé de se développer et fait partie des analyses réalisées systématiquement au diagnostic et au cours du suivi de la grande majorité des hémopathies malignes. Elle comprend le caryotype conventionnel et l'hybridation in situ fluorescente, ainsi que les puces génomiques et la cartographie optique du génome. La mise en évidence d'anomalies chromosomiques spécifiques constitue une composante essentielle au diagnostic et oriente la prise en charge des patients. La cytogénétique apparaît aussi comme un des facteurs pronostiques indépendants les plus forts dans les classifications en vigueur. Elle permet de stratifier et d'identifier les patients à haut risque d'évolution, guidant ainsi la thérapeutique. Dans certains cas, elle permet lְ'utilisation de thérapies ciblées orientées par l'identification de certaines anomalies. La cytogénétique reste donc une pierre angulaire de la stratégie diagnostique, pronostique et théranostique en onco-hématologie. Hematological malignancies constitute a heterogeneous group of pathologies classified according to clinical and biological criteria including cytogenetics and molecular biology. Hematological cytogenetics continued its development and remains one of the analyses routinely performed for the diagnosis and follow-up of most hematological malignancies. It includes conventional karyotyping and fluorescence in situ hybridization, as well as genomic arrays and optical genome mapping. The identification of specific chromosomal abnormalities is an essential component of diagnosis and guides patient management. Cytogenetics is also one of the strongest independent prognostic factors in current classifications. It can be used to stratify and identify patients with a higher risk of progression which allows to guide treatment. In certain cases, it opens to the use of targeted therapies based on the identification of specific abnormalities. Cytogenetics therefore remains a cornerstone of the diagnostic, prognostic and theranostic strategy in onco-hematology. [ABSTRACT FROM AUTHOR]

Arsenical medicine has obtained its status in traditional Chinese medicine for more than 2,000 years. In the 1970s, arsenic trioxide was identified to have high efficacy and potency for the treatment of acute promyelocytic leukemia, which promoted many studies on the therapeutic effects of arsenic trioxide. Currently, arsenic trioxide is widely used to treat acute promyelocytic leukemia and various solid tumors through various mechanisms of action in clinical practice; however, it is accompanied by a series of adverse reactions, especially cardiac toxicity. This review presents a comprehensive overview of arsenic trioxide from preclinical and clinical efficacy, potential mechanisms of action, toxicities, and rescue strategies for toxicities to provide guidance or assistance for the clinical application of arsenic trioxide. [ABSTRACT FROM AUTHOR]

Abstract Hematopoietic stem cells (HSCs) are the common and essential precursors of all blood cells, including immune cells, and they are responsible for the lifelong maintenance and damage repair of blood tissue homeostasis. The vast majority (> 95%) of HSCs are in a resting state under physiological conditions and are only activated to play a functional role under stress conditions. This resting state affects their long-term survival and is also closely related to the lifelong maintenance of hematopoietic function; however, abnormal changes may also be an important factor leading to the decline of immune function in the body and the occurrence of diseases in various systems. While the importance of resting HSCs has attracted increasing research attention, our current understanding of this topic remains insufficient, and the direction of clinical targeted treatments is unclear. Here, we describe the functions of HSCs, analyze the regulatory mechanisms that affect their resting state, and discuss the relationship between resting HSCs and different diseases, with a view to providing guidance for the future clinical implementation of related targeted treatments.

Hematopoietic stem cells (HSCs) are the common and essential precursors of all blood cells, including immune cells, and they are responsible for the lifelong maintenance and damage repair of blood tissue homeostasis. The vast majority (> 95%) of HSCs are in a resting state under physiological conditions and are only activated to play a functional role under stress conditions. This resting state affects their long-term survival and is also closely related to the lifelong maintenance of hematopoietic function; however, abnormal changes may also be an important factor leading to the decline of immune function in the body and the occurrence of diseases in various systems. While the importance of resting HSCs has attracted increasing research attention, our current understanding of this topic remains insufficient, and the direction of clinical targeted treatments is unclear. Here, we describe the functions of HSCs, analyze the regulatory mechanisms that affect their resting state, and discuss the relationship between resting HSCs and different diseases, with a view to providing guidance for the future clinical implementation of related targeted treatments. [ABSTRACT FROM AUTHOR]

Objective To analyze the distribution and drug resistance of pathogenic bacteria in blood- stream infection inpediatric hematology department, providing references of clinical empirical medication. Methods In this study, we retrospectively analyzed the BSI in children with hematological diseases from 2016 to 2021 at the second hospital of Anhui Medical University, including an assessment of the clinical characteristics, distribution of pathogens, and antibiotic resistance data. Results There were 145 patients with BSI, 155 strains of pathogenic were isolated from the patients, including 92 strains (59.3%) of gram-negative bacteria and 59strains (38.1%) of gram-positive bacteria. The top four proportion of pathogenic bacteria were coagulase - negative staphylococcus (20%), Klebsiella pneumonia (16.1%), Escherichia Coli (13.5%), and Pseudomonas aeruginosa (9.7%). The proportion of Pseudomonas aeruginosa increased gradually. The patients of acute myeloid leukemia (AML) were more likely to be infected with gram-positive bacteria than than acute lymphoblastic leukemia (ALL). There were 66.7% and 40.0% Klebsiella pneumonia and Escherichia Coli with extended-spectrum β-lactamase-producing respectively. Susceptibility rates of Klebsiella pneumonia and Escherichia Coli to carbapenems were 88.0% and 100.0%. Resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 26.6% and 13.3% respectively. Detection rate of Methicillin - resistant coagulase - negative staphylococci (MRCNS) and Methicillin - resistant staphylococcus aureus (MRSA) were 81.1% and 32.4% respectively. No bacteria with vancomycin-resistant and linezolid-resistant were found in staphylococcus. Conclusions The main pathogenic bacteria of BSI hospitalized in the pediatric hematology department is gram - negative bacteria, proportion of some species has increasing tendency. The patients of AML are more likely to be infected with gram-positive bacteria than the patients of ALL. Antibiotics should be selected rationally based on the diseases, distribution of pathogens and drug resistance. [ABSTRACT FROM AUTHOR]

Intravascular large B-cell lymphoma (IVLBCL) is a rare and highly malignant non-Hodgkin B-cell lymphoma with uncommon clinical presentation and poor prognosis. The diagnostic pitfall of IVLBCL is mainly due to the fact that subtle histological changes could be easily overlooked, in addition to its rare occurrence, non-specific and variable clinical presentations, and the absence of significant mass lesions. The purpose of this study is to further explore the clinicopathologic and molecular features of IVLBCL to ensure an accurate diagnosis of this entity. Here, we retrospectively present the data of the four new cases and the literature cases. The age ranged from 23 to 92, with a medium age of 67 and a male-to-female ratio of 1:1. The clinical manifestations are extremely variable, including fever, night sweats, weight loss, anemia, thrombocytopenia, unexplained hypoxemia, impaired consciousness, and skin lesions, as well as the extremely low levels of serum albumin, high levels of serum lactate dehydrogenase (LDH), soluble interleukin-2 receptor (sIL2R), and ferritin. Morphologically, 99.9% of cases showed a selective growth pattern with large, atypical lymphocytes within the lumen of small blood vessels. In addition, vast majority of cases were positive for CD20, CD79a, PAX5, MUM1, and BCL6, and a subset of cases expressed BCL2 and CD5, whereas CD3 and CD10 were typically negative. Ki-67 proliferative index ranged from 20% to 100%. To sum up, we have conducted comprehensive case reports, to the best of our knowledge, this is the largest reported cohort of IVLBCL cases. Comprehensive assessments and more IVLBCL cases are required for early diagnosis and prompt treatment. [ABSTRACT FROM AUTHOR]

Intravascular large B-cell lymphoma (IVLBCL) is a rare and highly malignant non-Hodgkin B-cell lymphoma with uncommon clinical presentation and poor prognosis. The diagnostic pitfall of IVLBCL is mainly due to the fact that subtle histological changes could be easily overlooked, in addition to its rare occurrence, non-specific and variable clinical presentations, and the absence of significant mass lesions. The purpose of this study is to further explore the clinicopathologic and molecular features of IVLBCL to ensure an accurate diagnosis of this entity. Here, we retrospectively present the data of the four new cases and the literature cases. The age ranged from 23 to 92, with a medium age of 67 and a male-to-female ratio of 1:1. The clinical manifestations are extremely variable, including fever, night sweats, weight loss, anemia, thrombocytopenia, unexplained hypoxemia, impaired consciousness, and skin lesions, as well as the extremely low levels of serum albumin, high levels of serum lactate dehydrogenase (LDH), soluble interleukin-2 receptor (sIL2R), and ferritin. Morphologically, 99.9% of cases showed a selective growth pattern with large, atypical lymphocytes within the lumen of small blood vessels. In addition, vast majority of cases were positive for CD20, CD79a, PAX5, MUM1, and BCL6, and a subset of cases expressed BCL2 and CD5, whereas CD3 and CD10 were typically negative. Ki-67 proliferative index ranged from 20% to 100%. To sum up, we have conducted comprehensive case reports, to the best of our knowledge, this is the largest reported cohort of IVLBCL cases. Comprehensive assessments and more IVLBCL cases are required for early diagnosis and prompt treatment.

Dans la plupart des dysglobulinémies, les protéines monoclonales ont une structure semblable aux molécules normales mais en quantité anormale. La maladie des chaînes lourdes (MCL) est une pathologie rare définie par la présence d'une immunoglobuline monoclonale (Ig) de structure anormale, constituée uniquement d'un fragment incomplet de la chaîne lourde (tronquée) et dépourvue de chaînes légères, remarquable par la fréquence des maladies immunologiques ou hématologiques associées. Les lymphocytes ou les plasmocytes anormaux sécrètent les différents types de chaînes lourdes (alpha [α], gamma [γ], mu [µ]ou delta [δ]) sans chaînes légères. La majorité des protéines des chaînes lourdes tronquées sont des fragments de leurs homologues normaux avec des délétions internes de longueur variable. Ces délétions semblent résulter de mutations structurales. On distingue quatre types de MCL selon l'isotype de chaîne lourde d'Ig produite par les cellules clonales : α, ν, µ ou δ. Le tableau clinique est plus proche de celui d'un lymphome que d'un myélome multiple. Le diagnostic des MCL et de maladies associées repose sur l'étude histologique des tissus atteints et sur l'analyse du sérum ou des urines. L'histologie, couplée aux immuno-marquages, montre une population monoclonale positive pour une chaîne lourde, mais négative pour les deux chaînes légères kappa (κ) et lambda (λ). La fréquence de mise en évidence d'une immunoglobuline monoclonale est variable et dépend du type de MCL. Le pronostic de ces maladies est très variable d'un patient à l'autre et le traitement n'est pas standardisé mais sera dirigé contre la prolifération sous-jacente. In most plasma cell disorders, monoclonal proteins have a structure similar to normal molecules but in abnormal amounts. Heavy chain disease (HCD) is a rare pathology defined by the presence of a monoclonal immunoglobulin (Ig) of abnormal structure, consisting only of an incomplete fragment of the heavy chain (truncated) and devoid of light chains, remarkable for the frequency of associated immunological or haematological diseases. Abnormal lymphocytes or plasma cells secrete the different types of heavy chains (alpha [α], gamma [γ], mu [μ] or delta [δ]) without light chains. The majority of heavy chain proteins are fragments of their normal counterparts with internal deletions of variable length. These deletions seem to result from structural mutations. There are 4 types of MCL according to the Ig heavy chain class produced by clonal cells: α, γ, μ or δ. The clinical presentation is closer to that of lymphoma than to multiple myeloma. The diagnosis of HCD and related diseases is based on the histological study of affected tissues and the analysis of serum or urine. The histological analysis with immunostaining shows a positive monoclonal population for a heavy chain, but negative for the two kappa (κ) and lambda (λ) light chains. The frequency of detection of the monoclonal peak is variable and depends on the type of HCD. The prognosis of these diseases is very variable from one patient to another and the treatment is not standardized. [ABSTRACT FROM AUTHOR]

Background: Multiple myeloma is a hematologic malignancy which confers a high venous thromboembolic risk. This risk is linked to patient‐related factors, disease‐specific mechanisms, and antimyeloma therapy, especially immunomodulatory drugs. Some studies have suggested that the thrombin generation assay may be a predictive marker of thrombosis. This study aimed to assess the hypercoagulable state in patients with multiple myeloma at diagnosis and after myeloma therapy. Methods: Thirty‐one patients with multiple myeloma were included in a prospective study and were compared with 31 matched controls with age and gender. Thrombin generation assay was performed in patients at diagnosis prior to treatment initiation and at the end of myeloma therapy, and in controls. Parameters of lag time, peak thrombin concentration, time to peak, endogenous thrombin potential, and velocity index were analyzed. Results: Median age of patients at diagnosis was 58 years (11 men and 20 women). Twenty‐three patients (74%) were classified as high vascular risk and received thromboprophylaxis. No thromboembolic events have been reported during follow‐up, except a symptomatic pulmonary embolism in one patient which occurred at diagnosis. At baseline, patients with myeloma had significantly elevated velocity index as compared to controls (178 vs 128 nmol/L/min; P = .013). High‐risk patients showed an elevation of plasma thrombin generation as compared to low‐risk patients (endogenous thrombin potential = 1244 vs 1052 nmol/L/min; P = .043). Myeloma therapy did not significantly change the thrombin generation parameters. Conclusion: Thrombin generation appears to be higher in patients with myeloma compared with controls, especially in high‐risk patients, and does not change significantly after treatment completion. [ABSTRACT FROM AUTHOR]

The author exposes the notion of medullary aplasia in Western medicine and in Eastern medicine by defining several clinical settings encountered and their treatment. He studies different protocols including acupuncture and Chinese phytotherapy alone or combined with conventional treatment. Then he exposes a clinical case of chronic medullary aplasia in which acupuncture relays a usual form of treatment. [ABSTRACT FROM AUTHOR]

Patients with autoimmune hemolytic anemia (AIHA) may require intensive care unit (ICU) admission. In order to describe the characteristics of AIHA patients in ICU and identify prognosis factors, clinical and biological data from 44 patients admitted in one ICU between 2002 and 2015 were retrospectively analyzed. The main reasons for ICU admission were profound anemia without any organ failure in 19 patients (either for safer transfusion or continuous monitoring only). Twenty-five (57%) patients had a past history of hemopathy. Twenty patients presented with a direct anti-globulin test (DAT) positive for immunoglobulin G (DAT-IgG) only (46%), 8 with a DAT positive for both IgG and complement (DAT-IgG+C) (36%), and 16 with a DAT positive for complement only (DAT-IgG+C) (18%). Corticosteroids and rituximab were administered to respectively 44 (100%) and 12 (25%) patients. Red blood cell transfusion was required in 28 (64%) patients. Ten (23%) patients received vasopressors. Renal replacement therapy was necessary in 14 (31.8%) patients. Thirteen (30%) patients died in the ICU. There was no difference between survivors and non-survivors regarding associated comorbidities like hemopathy (18/31 [58%] vs. 7/13 [54%], p = 0.80). In decedents, age was higher (72 years [57.8-76.3] vs. 50 years [34.3-64], p < 0.01) and organ dysfunctions were more severe at day 1 (SOFA 8 [7-11] vs. 5.5 [3-7], p < 0.01). Patients with a DAT-IgG displayed poorer outcome in comparison with patients with DAT-IgG+C/C (hospital mortality 69% vs. 36%, p = 0.04). Mortality rate of AIHA patients requiring ICU admission is consequential and appears to be impacted by age, organ failures, and DAT-IgG. [ABSTRACT FROM AUTHOR]

The prevalence of haematological malignancies increases in elderly patients. The complexity of therapeutic management makes it necessary to evaluate them using a global approach, namely bio-psycho-environmental. Identifying and assessing their weaknesses are part of the roles of advanced practice nurse (APN). Various tools are used to do this, including the G8 questionnaire, which directs patients towards a comprehensive geriatric assessment, or the Geriatric core dataset, designed to be used during clinical trials and which is more detailed and faster. Could an APN use the latter?, (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Objective: To investigate the influencing factors for the clinical efficacy of platelet transfusion in the treatment of patients with hemopathy. Methods: 156 cases of patients with hemopathy who were treated by platelet transfusion in our hospital from January 2013 to December 2015 were selected. All the patients were given 12 U platelet 2.5 x 1011), the corrected count increment (CCI) after transfusion and the effect of disease category, splenomegalia, fever, age, gender with on the clinical efficacy of platelet transfusion were analyzed. Results: The total effective rate of platelet transfusion was 71.0%, which was 65.9%, 65.7%, 77.7% and 71.9% in patients with aplastic anemia(AA), idiopathic thrombocytopenic purpura(ITP), acute leukemia(AL), myelodysplastic syndrome (MDS) respecctively, no significant difference was found between different disease categories (P>0.05). The effective rate was 69.9% in febrile patients, which was obviously lower than those non-febrile patients (77.6%, P<0.05); the effective rate was 74.9%, which was overtly lower than those with splenomegalia(52.86%, P<0.05); no significant difference was found in the effective rate between male and female, <60 years old and years old (76.5% vs. 75.8%, 72.0% vs. 113%){P>0.05). With the incease of transfusion times, the incidence of platelet transfusion refractoriness was gradually elevated (P<0.05). Conclusions: Splenomegalia and fever were adverse factors for the clinical efficacy of platelet transfusion in the treatment of patients with hemopathy. [ABSTRACT FROM AUTHOR]

Objectives: ANCA-associated vasculitis are severe autoimmune pathologies that are characterized by inflammation and necrosis of the small vessels. The physiopathological mechanisms are complex and have yet to be totally elucidated. Several environmental factors have been described as being associated: medications, infectious agents… and rarely, neoplasms.Methods: We performed a retrospective multicenter study over a period of 12 years with a view to describing the association of ANCA-associated vasculitis and malignant hemopathies, excluding hemopathies secondary to vasculitis treatment.Results: Sixteen patients with ANCA-associated vasculitis with an hemopathy were identified. The gender ratio was 7 and the mean age was 65 years. The frequency of this association is estimated at 1%. The ANCA-associated vasculitis were micropolyangiitis (n=7), followed by granulomatous polyangiitis (n=4), vasculitis limited to the kidney (n=3), and eosinophilic granulomatous polyangiitis (n=2). The associated malignant hemopathies were mainly non-Hodgkin's lymphoma in seven cases and myelodysplasia in five cases. The other hemopathies were: Hodgkin's disease, hypereosinophilic syndrome, and Waldenström's macroglobulinemia. Hemopathy treatment was associated with vasculitis treatment in seven cases.Conclusion: The association of ANCA-associated vasculitis and malignant hemopathy is rare but must nevertheless be recognized because: (i) the clinical signs of both pathologies are not specific, (ii) the survival scores that are used for ANCA-associated vasculitis do not appear to be applicable, (iii) both pathologies must be taken into account in order to implement an effective therapeutic strategy that limits the inherent risks. [ABSTRACT FROM AUTHOR]

Abstract: Kidney involvement is frequent in hematologic malignancies. It is associated with adverse outcome and treatment difficulties. It can affect every area of the renal parenchyma (tubules, interstitium, glomerulus, vessels). Various mechanisms could be implicated: deposits of immunoglobulin fractions or crystals, renal infiltration by malignant cells, urinary tract obstruction, paraneoplastic or storage glomerulopathies… Diagnostic strategy relies on the clinical presentation: acute renal failure, chronic kidney disease, glomerular proteinuria with or without nephrotic syndrome, tubular proteinuria, hydroelectrolytic disorders. In this review, we detail the diagnostic tests that are needed for the detection and the follow-up of renal involvement in hematologic malignancies, and clarify the indications of renal biopsy. We propose diagnostic strategies of renal involvement in myeloma, Waldenström''s disease, high grade lymphomas and acute leukemias, low grade lymphomas and chronic leukemias. The adverse effects of treatments (chemotherapy, radiotherapy, stem cell graft …) are not addressed in this review. [Copyright &y& Elsevier]

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Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an immune-mediated and treatable disease that may be associated with various systemic conditions. Our objective is to describe the clinical, electrophysiological and pathological data of a series of patients with both CIDP and hemopathy. In this retrospective study, we analyzed 21 patients with CIDP and various hemopathies (malignant or not), consecutively observed for almost five years. In this particular context (with a risk of neurological complications of the hemopathy), a nerve biopsy was taken from each patient (after written consent). All the patients fulfilled the EAN/PNS electrodiagnostic criteria (2021) of CIDP: 16 with 'CIDP' and 2 with 'possible CIDP' (no data for 3 patients). For each patient, pathological analysis of nerve biopsy was compatible with the diagnosis of CIDP, and there was no evidence for hematological complication of the peripheral nervous system. In cases of peripheral neuropathy and malignant hemopathy, the possibility that the peripheral neuropathy is CIDP should not be overlooked because CIDP is clearly accessible to appropriate therapies, with high potential for a positive clinical response. If the diagnosis of CIDP is usually suspected clinically and electrophysiologically, it should be confirmed by pathological study (nerve biopsy) in certain cases. The management of such patients benefits from the collaboration of neurologists, hematologists and oncologists. • Peripheral neuropathy can complicate numerous hematological malignancies and may also be secondary to treatment. • A nerve biopsy (NB) may be of value to identify the lesional mechanism. • CIDP should not be overlooked because CIDP is clearly accessible to appropriate therapies. • The management of such patients benefits from the collaboration of neurologists, hematologists and oncologists. [ABSTRACT FROM AUTHOR]

Acquired angioedema is often associated with significant morbidity. An underlying lymphatic malignancy, autoimmune disorder, adenocarcinoma, or other malignancy may be present. Screening for these disorders should occur in all patients with acquired angioedema as treatment may result in resolution of angioedema. [ABSTRACT FROM AUTHOR]

Hypervitaminemia B12 has been associated or linked with a range of conditions, the majority of which are serious. Between March 26 th , 2014 and June 30 th , 2014, all patients aged ≥65 years, hospitalized in an acute geriatric unit in the university hospital center of Reims (France) were included in an observational study. 190 patients were included. 48 patients presented a hypervitaminemia B12 (25.3%). The gender ratio (M/F) of the population with elevated vitamin B12 levels was 0.5. 41 patients were aged ≥75 years (85.4%). The mean vitamin B12 level was 1,085 pg/mL (±428). 30 patients (62.5%) presented with moderate hypervitaminemia (<1,085 pg/mL), while 18 patients (37.5%) presented with elevated levels >1,085 pg/mL. Using the Chi2 or Fisher tests and the Student test, the factors with a significant link to hypervitaminemia B12 in univariate analysis were: acute renal failure (p=0.0002); liver diseases (p <0.0001) and solid neoplasia (p=0.0030). Using binary logistic regression for multivariate analysis, variables independently related to hypervitaminemia B12 were: acute renal failure: (odds ratio [OR]=6.3; 95%CI=2.7-8.1; p <0.0001); liver diseases (OR=5.4; 95%CI=3.1-6.9; p <0.0001); hematological disorders (OR=5.7; p=0.001); and age ≥75 years (OR=3.7; 95%CI=1.9-4.8; p=0.04). Moreover, there is an apparent correlation between rates of hypervitaminemia B12 and the number of etiologies identified (r=0.8; p=0.04). Our study confirm the significance of the link between hypervitaminemia B12 and hematological disorders in elderly patients, with a 5.7 fold higher risk.

The endothelium and its integrity are in the center of numerous cardiovascular, pulmonary and tumoral diseases. Several studies identified different circulating cellular sub-populations, which allow a noninvasive exploration of endothelial dysfunction. Furthermore, angiogenesis plays a major role in the biology of benign and malignant hematologic diseases. Among these biomarkers, circulating endothelial cells could be considered as a marker of endothelial injury and/or endothelial activation as well as vascular remodeling, whereas circulating endothelial progenitor cells would be only involved in the vascular regeneration. In the future, the quantification of circulating endothelial cells in many diseases could be a noninvasive biomarker used in diagnosis, prognostic and therapeutic follow-up of lung vasculopathy and/or residual disease of hematological malignancies.

Cancers during infancy and childhood affect 1 to 3% of children under the age of 15. Among these cancers the most frequent are malignant hemopathies, and in particular, acute lymphoblastic leukemia, which represents 80% of infant leukemias, with a peak of incidence around the age of 3-4. The overall prognosis for infant malignant hemopathies has improved significantly thanks to progress made in chemotherapy and radiotherapy. However, these anti-cancer treatments, particularly radiotherapy, when performed early, generally before 5 years of age, can have harmful effects that interfere with overall growth and particularly cranio-facial growth, and also with the child's oro-dental development. Some effects such as mandibular retrognathia, macrodontia, microdontia, agenesis and delayed eruption could increase the need for orthodontic treatment, while other complications, particularly the reduced height of the alveolar processes, short thin roots and modification of the superficial and profound periodontium, are likely to make such treatment more difficult. The aim of this review of the literature is to identify the essential factors that must be analyzed before orthodontic treatment is proposed for subjects who have undergone radiotherapy at an early age, and the precautions to be taken before and during orthodontic treatment., (Copyright © 2015 CEO. Published by Elsevier Masson SAS. All rights reserved.)