New test piloted for childhood leukaemia

A new screening test to be piloted in Bristol could help to revolutionise the way children with leukaemia are treated by enabling doctors to fine tune treatment to the needs of each individual patient.

Experts from five centres – Bristol, Glasgow, Leeds, London and Sheffield – will pilot the test for the most common form of the childhood leukaemia – acute lymphoblastic leukaemia (ALL). The team at the University of Bristol and Bristol Royal Hospital for Children is using special technology called RQ- PCR (real time quantitative polymerase chain reaction) to measure the residual cancer cells – known as minimum residual disease – that remain after a child`s treatment.

All children treated for this cancer will have some residual leukaemia cells in their bone marrow that remain after the first month of chemotherapy. The level may fluctuate between 1/20 cells and 1/ 10,000 cells. Research in the UK and Europe has shown that the higher the level of residual disease the more likely a child is to relapse. Until now, the problem has been that conventional techniques are not sensitive enough to accurately measure the levels of residual leukaemia cells.

Dr Nick Goulden from the Bristol Royal Hospital for Children, says: “Preliminary studies have demonstrated that measuring residual disease enables us to predict whether a child will relapse. We hope that once this test is established in the UK doctors will be able to intervene at an earlier stage with more or less aggressive therapy based on the level of residual disease present in the blood and bone marrow.”

In total the five research teams have been awarded £500,000 from the Leukaemia Research Fund to carry out a feasibility study before the test can become a central component of the next national trial (see notes for editors).

Once the genetic fingerprint of a leukaemia cell has been identified, the residual cells can be quickly and accurately tested using the new RQ-PCR technology. This is a relatively new technique which allows scientists to amplify a given sequence of DNA millions of times within the space of a few hours.

One family who understands the importance of this research is the Baggley family from Taunton, whose daughter Olivia was diagnosed with acute lymphoblastic leukaemia in 1997 when she was five years old.

“It is only when you are faced with this disease that you realise how important research is to improving treatment,” says Olivia`s mother Deborah. “I hope this research will make treatment simpler and even help to save the lives of children who may otherwise have relapsed and died.”

Olivia – who is now 10 years – was treated with intensive chemotherapy at Bristol Royal Hospital for Children. When the disease returned early in January 2000 the doctors decided the best option was a stem cell transplant. She has now been in remission for two years.

Dr David Grant, Scientific Director of the Leukaemia Research Fund, said: “This is a key step forward which should lead to better treatment for every single child who is diagnosed with this terrible disease.”

“It should enable doctors to give more immediate and more appropriate treatment for children with a high risk disease. Equally, it would also allow doctors to identify children who could be cured with less intensive treatment, thereby reducing the gruelling side-effects of aggressive treatment,” he added.

Around 21,500 people are diagnosed with leukaemia or one of the related blood disorders in the UK every year.

Leukaemia Research Fund is the only national charity devoted exclusively to improving treatments, finding cures and learning how to prevent leukaemia, Hodgkin`s disease and other lymphomas, myeloma and the related blood disorders, diagnosed in 21,500 people in Britain every year.

Further information, including patient booklets, is available from:
· your nearest LRF voluntary fundraising Branch (see Yellow Pages)
· LRF, 43 Great Ormond Street, London, WC1N 3JJ tel 020 7269 9068; emailinfo@lrf.org.uk; www.lrf.org.uk.

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