Working together to beat childhood blood cancer
Following the fantastic news last year that research supported by Bloodwise and the charity Children with Cancer UK is helping to more accurately tailor treatment for children with leukaemia, we take a look at other projects where we have collaborated to improve the treatment of childhood blood cancers.
Over 400 children under the age of 15 are diagnosed with leukaemia every year in the UK. There have been significant improvements in survival rates, driven not by new drugs, but by greater understanding of drug combinations and tests that make it possible to use them to the greatest effect.
We want to reach a day when no child dies from leukaemia and, in parallel, to reduce the toxicity of treatment. No child should lose their childhood to years of gruelling treatment and no child should suffer poor health in later life due to long term side-effects, including heart disease, infertility and the possibility of developing a second cancer. And we know that we will only get there through research.
Tailoring childhood leukaemia treatment
The minimal residual disease (MRD) test measures how children with the most common form of leukaemia - acute lymphoblastic leukaemia (ALL) – respond to their initial treatment. Children with Cancer UK provided funding for the test to be used and analysed on a Bloodwise and Children with Cancer UK-funded national clinical trial (UKALL 2003) for children treated for leukaemia between 2003 and 2011.
The results showed that treatment can be eased off if levels of leukaemia cells drop below a certain level after induction chemotherapy, limiting side effects but not affecting these children’s chance of a cure. MRD testing has since been adopted as standard of care in the NHS for children with ALL.
Investigating increased risk of leukaemia in children with Down syndrome
Children with Down syndrome have a 150-fold increased risk of developing acute myeloid leukaemia in the first five years of life. One in 10 of newborn babies with Down syndrome have a pre-leukaemic condition known as transient abnormal myelopoiesis (TMD), which in most cases does not go on to develop into leukaemia.
Together with Children with Cancer UK, we are funding researchers based at Imperial College London and University of Oxford, who are investigating how the diagnosis and treatment of leukaemia can be improved in babies with Down syndrome and whether leukaemia could even be prevented in these children.
Providing high-quality leukaemia samples for life-saving research
CellBank, which collects and stores biological samples from children with different types of leukaemia, is an invaluable resource to researchers in the UK and around the world.
The samples are usually taken at diagnosis, relapse and follow-up, with linked key demographic and disease information. They are held in the facility created for the UK Biobank study in Stockport, with state of the art infrastructure and sample handling processes. We have previously worked with Children with Cancer UK to set up this vital facility, which now holds over 85,000 samples of biological material from more than 7,000 children.
Samples are being used by researchers to find out more about the origins of childhood leukaemia and predicting which children will respond to treatment. Large population studies have used Cellbank to determine areas of genetic risk for developing childhood ALL, and have provided new insights into which genetic causes are behind the disease.
Uncovering the origins of leukaemia
In a Bloodwise study looking at twins, one of whom developed leukaemia and one who did not, Professors Mel Greaves and Tariq Enver demonstrated that the initial mutations to healthy cells that will eventually lead to childhood leukaemia actually occur in the womb. A second ‘trigger’ during childhood, perhaps an abnormal response to infection, is thought to be needed for leukaemia to develop in children who carry these leukaemia stem cells.
Led by Prof Greaves, we worked with Children with Cancer UK to support the next steps of this project, where early leukaemia cells were analysed in the laboratory to establish exactly what needs to happen to trigger this form of cancer to fully develop.