Leukaemia breakthrough
SCIENTISTS FROM NEWCASTLE MAKE CHEMO DISCOVERY
CHILDREN with leukaemia could receive significantly improved treatment thanks to a breakthrough in cancer cell screening by Newcastle scientists.
A study has shown current methods used to determine the correct level of chemotherapy for each young patient may be improved by looking at the genetic make-up of the child’s cancer cells.
The findings have already led to changes to treatment tailoring for newly diagnosed children, with around half of youngsters with good risk genetics being spared intensive treatment. The results may also be used to identify those children at the highest risk of relapse who would benefit most from new types of treatment, such as CAR-T cell therapy.
The research, by scientists at Newcastle University and doctors at Great Ormond Street Hospital and the Bristol Royal Hospital for Children, was funded by the blood cancer research charity Bloodwise. The study is published online today in the Journal of Clinical Oncology.
Methods currently used to guide intensity of treatment for each child relies heavily on a test – known as minimal residual disease (MRD) – that measures levels of leukaemia cells remaining in the blood after the first month of chemotherapy.
MRD gives a clear indication of how quickly a patient is responding to treatment. Children are placed into ‘low risk’ or ‘high risk’ treatment regimes, based on whether the number of leukaemia cells detected by their MRD test is above or below a single threshold.
A team from the Northern Institute for Cancer Research, Newcastle University, analysed leukaemia cells from more than 2,500 children whose treatment had been guided by the MRD test between 2003 and 2011.
The research has shown that combining the results of MRD analysis with genetic profiling doctors will be able to significantly improve the accuracy of predicting relapse of the disease and improving treatment options.
Anthony Moorman, a Professor of Genetic Epidemiology, who coleads the Leukaemia Research Cytogenetics Group at Newcastle University, said: “This study indicates that using a traditional MRD threshold to assign patients to different treatment groups should be refined with the integration of detailed genetic testing, to more accurately identify children with a lower or higher risk of relapse.
“Taking into account key genetic abnormalities that influence outcome will ensure that MRD thresholds for more or less intensive chemotherapy are more flexible and each child gets the most appropriate treatment.
“The idea of combining or integrating MRD and genetic information to refine the allocation of patients to different risk groups has been fully adopted in the next clinical trial, which is currently being designed and will hopefully begin in late 2018.”