Towergate met with Tim Milne, a senior clinical scientist at the
Institute of Child Health, to hear how work was progressing on
research into better ways to treat severe childhood leukaemia at
Great Ormond Street Hospital.
Tim, how are things going on the research
project?
Well thanks to Towergate’s support, the
research is fully up and running - and we’ve started to have
some very promising early results.
Can you talk us through what’s been
going on over the last 6 months?
We’ve been focussing on children with a type
of acute lymphatic leukaemia (b-ALL), one of the most common forms
of leukaemia in children under 11 years old. At the moment,
these children undergo chemotherapy to try and kill off the
leukaemic cells in their blood. Unfortunately, even when
successful, this treatment has severe side effects which can
compromise a child’s growth and fertility, and make them very
ill.
What’s the major challenge in treating
these children?
The critical factor is making sure we’re not
over-treating children with milder forms of leukaemia, or
under-treating those with severe forms. Finding this balance
is extremely difficult – and getting it wrong has huge
consequences. Too much chemotherapy and the child could have
terrible side effects that stay with them for the rest of their
life. Too little and the leukaemia could return -
potentially much more aggressively, which means it’s far harder to
treat.
How do existing treatments for acute
leukaemia deal with this problem?
Currently, children have a standard course of
chemotherapy over 28 days - during which we test samples of
their DNA for telltale signs of leukaemic cells. At the end of
the 28 days, we see whether or not the DNA tests indicate that
leukaemia is still present. If so, the child might have to
have more intensive therapy like a bone marrow transplant. If
not, and things are looking good, then we continue to test the
patient to be sure the leukaemia doesn’t return.
And how does this research aim to
help?
By using a new machine that counts individual
leukaemic cells in a sample of patient’s tissue (either blood or
bone marrow), we can get a much clearer picture of how severe the
leukaemia is. Over the course of the chemotherapy, we can
figure out how well our treatment is getting rid of
the leukaemia, by looking at how quickly the number of leukaemic
cells reduce in each sample. The great thing about this new
test is that it gives us these results faster and much more cheaply
than the existing DNA tests.
What will this mean?
Because the new test gives us results in a
matter of hours - as opposed to weeks - it means we will
know how well a child is responding to chemotherapy, before the end
of their 28 day course of treatment. This means we’ll be able
to identify high-risk patients sooner which, in turn, is the first
step to putting them on a more intensive course of
chemotherapy. Having this extra level of treatment could mean
we prevent relapse in these children, and stop them from going on
to need a bone marrow transplant. Alternatively, if we see
that all the leukaemic cells have gone before the 28 days are up,
it may mean we can stop chemotherapy early - so ultimately
less side effects for the child.
Are you confident the research will be
a success?
We hope so! In fact, the early work is
going so well that we’ve started on two further applications of the
new test - one in very young babies, and also children with a
different type of leukaemia, t-ALL. We’ve also started work
early on a project that had been planned for next year, applying
this new test to children with acute myeloid leukaemia (AML), a
rarer but much more aggressive type of leukaemia. Having this
head start means we’re in a fantastic position to scale up our
research to the point where children will begin to see
benefits. It’s wonderful to see things develop so
quickly - so thank you Towergate for all your support!
