The use of Minimal Residual Disease detection to improve treatment outcome in childhood acute lymphoblastic leukaemia

使用微小残留病检测来改善儿童急性淋巴细胞白血病的治疗结果

• 批准号: nhmrc : 350886
• 负责人: Prof Glenn Marshall
• 金额: $ 24.98万
• 依托单位: The University of New South Wales
• 依托单位国家: 澳大利亚
• 项目类别: NHMRC Project Grants
• 财政年份: 2005
• 资助国家: 澳大利亚
• 起止时间: 2005-01-01 至 2007-12-31
• 项目状态: 已结题
• 来源: https://researchdata.edu.au/use-minimal-residual-lymphoblastic-leukaemia/94827
• 关键词: use; Minimal; Residual; Disease; detection

Leukaemia is the most common childhood cancer, representing approximately 35% of all cases. Despite intensive therapy, the disease frequently recurs in the bone marrow and although children are classified into good and poor prognosis groups at diagnosis based on a number of criteria, relapses nevertheless occur in both groups. Evidence obtained by ourselves and others, suggests that early detection of poor treatment response in the otherwise good prognosis group, and the implementation of alternative therapy when the cancer burden is at a low level, has a high likelihood of improving patient survival. In this regard, we have recently developed a novel molecular genetic technique that can detect and quantitate very low levels of residual leukaemia with great sensitivity and specificity. This technique is ideally suited for use in the routine clinical setting, and as a result of this development, we have now established a clinical trial (ANZCCSG Study VIII) in which patients who have a bad result on this test, will be given more intensive treatment to see if this improves survival rates. A number of research questions will also be addressed in this trial including whether the level of residual leukaemia at the end of therapy is able to predict future relapse that would otherwise not be suspected. It is anticipated that the clinical trial will help define the most appropriate treatment strategies for children with leukaemia. This project, which is at the forefront of such studies worldwide, has major implications for the therapeutic management of children with leukaemia and has the potential of contributing directly to the improved survival of this most common of childhood cancers.

白血病是最常见的儿童癌症，约占所有病例的35%。尽管进行了强化治疗，但这种疾病经常在骨髓中复发，尽管儿童在诊断时根据一些标准被分为预后良好和预后不良组，但两组都有复发。我们和其他人获得的证据表明，在预后良好的人群中早期发现不良治疗反应，并在癌症负荷处于低水平时实施替代治疗，很有可能改善患者的生存率。在这方面，我们最近开发了一种新的分子遗传技术，可以检测和定量非常低水平的残留白血病，具有很高的灵敏度和特异性。这种技术非常适合在常规临床环境中使用，由于这种发展，我们现在已经建立了一项临床试验（ANZCCSG研究VIII），在该试验中，对这种测试结果不好的患者将给予更强化的治疗，以观察这是否会提高生存率。本试验还将解决一些研究问题，包括治疗结束时残留白血病的水平是否能够预测未来的复发，否则将不会被怀疑。预计该临床试验将有助于确定白血病儿童最合适的治疗策略。这一项目处于全世界这类研究的前沿，对白血病儿童的治疗管理具有重大意义，并有可能直接有助于提高这一最常见的儿童癌症的生存率。