When Joseph Green woke up one day during November 2009 with a red, swollen toe, it looked to his dad, Stephen, like a simple infection. But just three days later, Joseph was beginning a gruelling three and a half years of chemotherapy after being diagnosed with leukaemia. He was then just five years old, and the diagnosis hit the family hard.
Stephen said: “It is the worst feeling you can imagine, just such a shock. It was his brother’s birthday as well, so he had to open his presents in the hospital. It just transforms your life when you get a diagnosis like that.” During periods of his treatment at the Royal Victoria Infirmary in Newcastle, Joseph was taking 17 different tablets and having injections in his spine every three months. But then, in 2013, the family got the welcome news that Joseph was in remission. He is now in school and is able to get back to his Karate lessons. Stephen added: “He was so brave during the whole thing, he even stood in front of his class at school to tell them what was wrong with him.”
Treating Leukaemia in the Future
by Professor Christine Harrison
Joseph was diagnosed with acute lymphoblastic leukaemia (ALL), a cancer of the white blood cells, which is the most common childhood cancer. Thanks to improved treatments and disease monitoring, up to 90 per cent of children with ALL are now cured. Research at Newcastle University into the underlying genetics of ALL has contributed to improving the survival rate. Years of study, including research within our own group, the Leukaemia Research Cytogenetics Group, has shown that genetic abnormalities in ALL predict the way in which patients respond to therapy. As a result, these abnormalities are used to guide the choice of treatment for individual patients.
‘Good risk’ abnormalities are present in about half of children with ALL, and patients with these abnormalities have an excellent outcome on standard treatments. Unfortunately, a minority of patients do not respond to standard treatment, resulting in a high risk of relapse. Much of our research has focussed on improving outcome in these ‘poor risk’ patients.
Ten years ago, we discovered an unusual genetic abnormality among poor risk patients, known as iAMP21. We found that this abnormality was present in around two per cent of children diagnosed with ALL and that it gave them a much greater chance of suffering a relapse and a much lower long-term chance of survival. Since 2003, every child diagnosed with ALL has been tested for the presence of this abnormality using a genetic test designed by our research group. Once identified, they are immediately recommended for very intensive treatment. Recent results after long-term follow up have shown that children in this group treated with intensive chemotherapy had their risk of relapse reduced by 75 per cent, and the proportion surviving for five years or more increased to nearly 90 per cent. These results demonstrate the huge potential of personalised medicine.
These discoveries have been possible because we maintain the largest cytogenetic database in the world, containing genetic data from more than 27,000 children and adults diagnosed with acute leukaemia treated on UK and international clinical trials. New laboratory space would enable us to continue to develop our research in this area and would ultimately result in even more lives being saved. It would also enable us to build on our equally important work into the reduction of the long-term side-effects of treatment.
The Newcastle University Centre for Childhood Cancer will enable us to continue to develop our research in this area and will ultimately result in more lives being saved. It will also enable us to build on our equally important work into the reduction of the long-term side effects of treatment.