A team of oncologists and research scientists working across different hospitals and UK universities have recently published a study in the Journal of Clinical Oncology that brings hope to children with Leukaemia.
Leukaemia can exist as different types but the majority of cases affecting children are called Acute Lymphoblastic Leukaemia (ALL). ALL manifests itself most often in young children (1 to 4-year-olds) and numbers show that 400 children will be affected each year by this disease in the UK, accounting for one-third of all childhood cancers.
Leukaemia arises when the bone marrow makes too many lymphocytes (a type of white blood cells) that remain immature and never become functional. Mature lymphocytes circulate in the blood and are needed to fight infections as part of a healthy immune system. The leukaemic cells can be targeted by multiple rounds of effective but toxic chemotherapy treatments which are sadly accompanied by terrible side effects for the child’s body. Indeed, this highly toxic treatment can affect fertility and cause heart problems in later life.
The current guidelines that doctors use to predict the chance of each child to remain cancer-free following a round of treatment are to measure how many cancer cells are left in the patient blood. This measurement is used to determine if a child needs to receive more aggressive chemotherapy (and more bad side effects). Doctors have observed that each patient’s cancer is different and some might go into remission whereas some don’t with a similar number of cancer cells left after treatment. This crucial difference lies in the nature itself of cancer. Every person is unique thanks to its own set of genes and chromosomes. That is also true for cancer cells that carry different types of genetic aberrations. This uniqueness has a big impact on how the cancer cell gets affected by the drugs given during chemotherapy.
The implications are huge for little patients! It means that some children could be spared unnecessary rounds of treatment and still get better! On the other hand, doctors also need to identify the children with leukaemia who are likely to relapse in order to carry on with an aggressive treatment as these children have a poorer outcome, with fewer than 6 in 10 surviving longer than five years.
Finding these different categories of ALL patients was the aim of this study and their results are very promising.
The clever trick is to combine information about the patient’s cancer genes (specific gene abnormalities that are often found in leukaemia cells) to the information about the response to the initial treatment. The results were very encouraging in the 3000 patients that were studied over the last 7 years. This new approach, if implemented on the global scale, could see the five-year survival rate of young patients increase significantly, bringing new hope for children with Leukaemia.
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