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HIF-dependent signalling can boost cancer and stromal cell adaptability and selection to their surroundings, leading to changes that favour cancer growth

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doi: 10.1093/bioinformatics/btu170 32 PatroRDuggalGLoveMIIrizarryRAKingsfordC

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The incidence of isolated CNS relapse is less than 5%, and testicular relapse is less than 1% to 2%.[213-215] As with bone marrow and mixed relapses, time from initial diagnosis to relapse is a key prognostic factor in isolated extramedullary relapses.[216] In addition, age older than 6 years at relapse was noted in one study as an adverse prognostic factor for patients with an isolated extramedullary relapse, while a second study suggested age 10 years as a better cutoff.[17,217] Of note, in most children with isolated extramedullary relapses, submicroscopic marrow disease can be demonstrated using sensitive molecular techniques,[218] and successful treatment strategies must effectively control both local and systemic disease