The study identifies the risk of some children with childhood cancer who develop secondary leukemia

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Bone marrow aspirate with acute myeloid leukemia. Several explosions have Auer rods. Credit: Wikipedia

Scientists at the Wellcome Sanger Institute and the University of Cambridge found that in children with neuroblastoma – a cancer of immature nerve cells – treatment with platinum chemotherapy caused changes in the genome that could later cause leukemia in some children later. .

The findings, published on May 27, 2021 a Blood it could lead to the ability to identify which children are most likely to develop . In turn, this could lead to changes in your treatment plan to avoid these risks or take steps to prepare.

Secondary cancer is a difficult complication of childhood cancer treatment. Every year, in the UK, about 100 children are diagnosed with neuroblastoma * and those who received high-risk treatment of developing secondary blood cancer (leukemia) after treatment with neuroblastoma.

Neuroblastoma often requires intensive treatment, including various chemotherapy drugs. These powerful drugs kill cancer cells very effectively, but unfortunately they also have side effects, such as damaging the DNA of healthy cells, including those in the bone marrow. Up to 7% of childhood neuroblastoma survivors, damaged bone marrow cells turn into secondary leukemia.

In this new study, researchers at the Wellcome Sanger Institute and the University of Cambridge sequence the entire genomes of the bone marrow and of two children who had both developed blood cancer after treatment with high-risk neuroblastoma. They found that the seeds of secondary leukemia were seeded by chemotherapy with neuroblastoma right at the start of treatment.

Dr Sam Behjati, lead co-author and group leader at the Wellcome Sanger Institute, said: “We have been able to reveal the root of secondary leukemia in these children who appear to be in the early stages of treatment. with neuroblastoma. We hope you investigate this further to try to identify children at higher risk and report on a more appropriate treatment plan to reduce the risk of secondary leukemia. “

The team found that in both patients the leukemia had mutations caused by neuroblastoma chemotherapy. A larger analysis of 17 children treated for a variety of cancers identified another child who had been treated with neuroblastoma and who had then developed pre-leukemia. In the future, children at higher risk of developing secondary leukemia could be identified by sequencing their genome and highlighting the genetic drivers that may be precursors to blood cancer.

Dr Grace Collord, first co-author of the Wellcome Sanger Institute, said: “This research would not have been possible without the contributions of patients and their families, and we are indebted to them for their participation in this study. Understand the reason why some childhood cancer survivors continue to develop secondary blood cancer is crucial if we are to find a way to help protect us from this devastating complication. “

Professor John Anderson of Great Ormond Street Hospital, who contributed to this study, said: “Neuroblastoma can be an aggressive disease that requires intensive chemotherapy treatment. it can cause serious side effects such as leukemia. Therefore, these findings are important to inform of possible secondary cancer control strategies and to tailor individual treatment plans. However, I must emphasize that it is still vital that with high-risk neuroblastoma continue to receive intensive treatment for their . ”


Multimodal therapy may be key to the treatment of aggressive childhood cancer


More information:
Tim HH Coorens et al, Clonal hematopoiesis and myeloid neoplasms related to therapy after neuroblastoma treatment, Blood (2021). DOI: 10.1182 / blood.2020010150

Newspaper information:
Blood


Citation: Study Identifies Risk of Some Childhood Cancer Patients Developing Secondary Leukemia (2021, May 28) Retrieved May 29, 2021 at https://medicalxpress.com/news/2021-05-childhood-cancer -patients-secondary-leukemia.html

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