Funded by The Little Princess Trust and administered by CCLG
Lead investigator: Dr Chris Halsey, University of Glasgow
Award: £247,415
Awarded December 2020
Acute lymphoblastic leukaemia (ALL) is the commonest cancer in children. Cure of ALL requires eradication of leukaemia cells that hide in fluid around the brain, called cerebrospinal fluid (CSF).
Treatment involves up to 26 chemotherapy injections into the CSF via spinal-tap under sedation/anaesthetic. Current tests to detect leukaemia in CSF are crude, so treatment is given to all children and young-adults, without knowing how much is really needed. This treatment can cause damage to the developing brain.
Short-term side-effects include fits (affecting about 1-in-10 patients). Longer-term side-effects include reductions in intelligence, attention span and memory (affecting about 1-in-3 patients).
The next childhood, teenage and young adult ALL trial - ALLTogether1, involves 14 European countries.
It includes a scientific sub-study, led by a UK team, called CSF-FLOW. Flow cytometry uses lasers to detect leukaemia cells based on their unique physical and chemical characteristics. The team will collect CSF during chemotherapy treatments and use flow cytometry to accurately measure the amount of leukaemia in the CSF and how quickly it responds to treatment. They will also freeze some CSF to allow rapid testing of any future discoveries.
The team plan to use this information to identify children with:
- very low amounts of leukaemia in the CSF who might be able to receive less brain-directed chemotherapy(to be tested in a future clinical trial).
- very high amounts of leukaemia in the CSF, or other high-risk features, who might be better cured with different treatment approaches (again to be tested in a future clinical trial)