To identify the drivers of relapse acute leukaemia in paediatrics

• Research type

  Research Study

• Full title

  To test the hypothesis that increased exposure of infections is related to an increased risk of relapse in childhood acute lymphoblastic leukaemia by undertaking a retrospective study using clinical cohorts to enable tracking of the evolution of the disease with a focus on key factors for relapse such as infection. To evaluate if other factors such as ethnicity, socio-economic status together with MRD status have a role in relapse in childhood acute lymphoblastic leukaemia and to formulate a prognostic scoring system that will incorporate ethnicity and socio-economic status that will help to predict relapse. To identify if there is any unmet meets for access for stem cell transplantation/CAR-T cell therapy for patients who relapse with childhood ALL.

• IRAS ID

  334939

• Contact name

  Cristina Lo Celso

• Contact email

  c.lo-celso@imperial.ac.uk

• Sponsor organisation

  Imperial College London

• Duration of Study in the UK

  1 years, 7 months, 6 days

• Research summary

  Original text:
  Research Question:
  To investigate the drivers of relapse of childhood acute lymphoblastic leukaemia

  To test the hypothesis that increased exposure infections is related to an increased risk of relapse in childhood acute lymphoblastic leukaemia by undertaking a retrospective study using clinical cohorts and longitudinal cohorts to enable tracking of the evolution of disease with a focus on key risk factors for relapse such as infection.

  Background
  The hypothesis that infection might have a crucial role to play in the incidence of a new diagnosis of childhood ALL is around 100 years old (1).

  Relevance to patients public

  If there is a link between common infections and relapse in childhood ALL to identify a leukaemogenic virus which is linked to relapse in childhood acute lymphoblastic as to whether these patients could be candidates for targeted therapy such as antivirals or immunomodulatory drugs such as Immunoglobulin.

  Analytical Strategy
  This will involve contacting and visiting the tertiary paediatric haem-onc centres in the United Kingdom to have access to the patient notes with childhood acute lymphoblastic leukaemia.
  To review the notes of the clinical history of thepatients with relapse refractory childhood acute lymphoblastic leukaemia from remission to relapse.
  To review if a prognostic scoring system could be devised with regards to socio-economic status and ethinicity, minimal residual disease at remission, cytogenetics which would help to predict relapse.

  In the future, when patients will be considered for de-escalated therapy for the treatment of childhood acute lymphoblastic leukaemia, the results of this research will help to guide whether patients of low socio-economic status and certain ethnic background should be considered more carefully for de-escalated therapy
  Ultimate aim to inform more effective targeting of resource to optimise care of patients to prevent relapse of childhood ALL

  References
  1. Ward G. The infective theory of acute leukaemia. Br J Child Dis. 1917; 14:10–20.

• REC name

  East of England - Essex Research Ethics Committee

• REC reference

  24/EE/0056

• Date of REC Opinion

  19 Jun 2024

• REC opinion

  Further Information Favourable Opinion