Looking for an earlier, less damaging treatment for acute lymphoblastic leukemia (ALL)

Acute lymphoblastic leukaemia (ALL) is a type of cancer in which the bone marrow makes too many immature lymphocytes (a type of white blood cell). Once a death sentence, ALL is now curable in 80-90 per cent of cases. While this is a wonderful achievement, treatment can result in a variety of adverse outcomes, such as secondary cancers, organ failure and infertility.

It is now known that childhood ALL begins before birth, however the mechanisms by which this happens are not understood. With a view to finding less harmful treatments for childhood ALL, Professor Ian Morison and his team are investigating potential progenitor cells that could lead to the development of ALL in the future.

Recent laboratory work, using cord blood collected from neonates, suggests that Professor Morison’s team have identified the existence of ALL progenitor cells. Further testing, mostly using cord blood of premature neonates, will see if these cells occur more frequently in premature babies.

The team will also test liver cells for ALL progenitor cells, as this is the earliest site of lymphocyte formation in embryos. Research into infantile haemangiomas (IH), aka strawberry naevus birthmarks, suggests IH growths produce fetal-type blood cells that are highly responsive to beta-blocker treatment. If ALL has a similar provenance, which is highly plausible, this work could lead to an earlier, more effective treatment for ALL that’s not unlike that used for IH.

The ideal outcome would be early-life, even prenatal, screening for ALL that would flag the need for prophylactic treatment and greatly improve the long-term prognosis for this condition.