{"id":938,"date":"2020-08-26T09:32:18","date_gmt":"2020-08-26T09:32:18","guid":{"rendered":"https:\/\/clinlabint.3wstaging.nl\/missing-dna-fragments-hold-clue-to-predicting-childhood-leukaemia-relapse\/"},"modified":"2021-01-08T11:08:59","modified_gmt":"2021-01-08T11:08:59","slug":"missing-dna-fragments-hold-clue-to-predicting-childhood-leukaemia-relapse","status":"publish","type":"post","link":"https:\/\/clinlabint.com\/missing-dna-fragments-hold-clue-to-predicting-childhood-leukaemia-relapse\/","title":{"rendered":"Missing DNA fragments hold clue to predicting childhood leukaemia relapse"},"content":{"rendered":"

Australian researchers have developed a new risk scoring system for children with leukaemia based on missing DNA fragments or \u2018microdeletions\u2019.<\/span>
\nThe risk score will allow doctors to better predict the chance of relapse of a subgroup of kids currently hidden in a lower risk group. <\/span>
\nThe international study, led by Australian researchers at Children\u2019s Cancer Institute, discovered that searching for specific gene microdeletions found only in leukaemia, when combined with two other test results, provides doctors with a more accurate way to categorise patient risk than the current approach.<\/span>
\nThe study tested 475 patients from 6 different children\u2019s hospitals in Australia and New Zealand enrolled on a clinical trial sponsored by ANZCHOG, the Australian and New Zealand Children\u2019s Haematology and Oncology Group.<\/span>
\nThe patients were all children with non-high-risk B-cell precursor acute lymphoblastic leukaemia (BCP-ALL), a subtype of acute lymphoblastic leukaemia (ALL), the most common childhood cancer with survival rates typically near 90%. Most children with ALL have B-cell precursor acute lymphoblastic leukaemia.<\/span>
\nStudy leader, Associate Professor Rosemary Sutton, said the most intensive treatment for BCP-ALL patients was usually given to the 11% or so of children in the high-risk category to limit side effects for kids who don\u2019t need it.<\/span>
\n\u201cChildren in the standard and medium risk category in the study were given less intensive treatment than high-risk patients. But about one in six of them relapsed. Obviously, some children needed more intensive treatment than previously thought \u2013 but which ones?\u201d she said.<\/span>
\nProf Sutton said she and her collaborators developed a new kind of risk score which builds on a bone marrow test, the minimal residual disease or MRD test developed at Children\u2019s Cancer Institute, which gives doctors early warning that treatment may not be working.<\/span>
\nThe MRD test is so sensitive it can detect just one cancer cell in a million bone marrow cells surviving cancer treatment. The test was a huge boon for some children with leukaemia on this same trial, since it alerted doctors that they had a very high risk of relapsing.  <\/span>Consequently, they were treated very intensively with chemotherapy and bone marrow transplants, and the survival rate of this subgroup doubled. But MRD alone is not enough.
\n\u201cFor the standard to medium risk group, we needed more information to get a better handle on the biology of the child\u2019s cancer to better determine their risk\u201d, said Prof Sutton.<\/span>
\n\u201cSo, we supplemented MRD results with two other pieces of patient information, the presence or absence of specific gene microdeletions and a score called the NCI (National Cancer Institute) risk, based on age and white blood cell count.<\/span>
\n\u201cWe tested for microdeletions in 9 genes involved in leukaemia and found that two of the genes, IKZF1 (called \u2018Ikaros\u2019) and P2RY8-CRLF2, were important predictors of relapse,\u201d she said.<\/span>
\nThese measures were combined to calculate a risk score for each patient of \u20180\u2019 (no risk factors), to \u20182+\u2019 (several). The study found that children with a \u20182+\u2019 score were most likely to relapse or die within 7 years after treatment started, while those with a \u20180\u2019 score least likely.<\/span>
\nThe same microdeletions were found to be important for predicting relapse in a cohort of Dutch children with leukaemia and the new scoring system was validated by researchers in The Netherlands.<\/span>
\nIf the new risk score system is adopted in future, doctors could give children with a \u20182+\u2019 risk more intensive treatment with the aim of improving their survival.<\/span>
\nDr Toby Trahair, paper co-author and oncologist at Kids\u2019 Cancer Centre at Sydney Children\u2019s Hospital, Randwick said the scoring system could make a big difference to the success of childhood leukaemia treatment.<\/span>
\nChildren\u2019s Cancer Institute<\/span>
\nccia.org.au\/missing-dna-fragments-hold-clue-predicting-childhood-leukaemia-relapse\/<\/link><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Australian researchers have developed a new risk scoring system for children with leukaemia based on missing DNA fragments or \u2018microdeletions\u2019. The risk score will allow doctors to better predict the chance of relapse of a subgroup of kids currently hidden in a lower risk group. The international study, led by Australian researchers at Children\u2019s Cancer […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[35],"tags":[],"_links":{"self":[{"href":"https:\/\/clinlabint.com\/wp-json\/wp\/v2\/posts\/938"}],"collection":[{"href":"https:\/\/clinlabint.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/clinlabint.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/clinlabint.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/clinlabint.com\/wp-json\/wp\/v2\/comments?post=938"}],"version-history":[{"count":0,"href":"https:\/\/clinlabint.com\/wp-json\/wp\/v2\/posts\/938\/revisions"}],"wp:attachment":[{"href":"https:\/\/clinlabint.com\/wp-json\/wp\/v2\/media?parent=938"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/clinlabint.com\/wp-json\/wp\/v2\/categories?post=938"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/clinlabint.com\/wp-json\/wp\/v2\/tags?post=938"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}