Cancer Research UK launches trial of new drug to treat acute childhood leukaemia

Friday 27 January 2012

Cancer Research UK Press Release

Cancer Research UK’s Drug Development Office has opened the first trial of a new type of drug to treat children aged from six months to 18 years with acute leukaemia, who are no longer responding to treatment.

In this first-in-child study, 15 children with acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) will receive a treatment called AT9283. AT9283 belongs to a new class of drugs called aurora kinase inhibitors.

The trial is led by Great North Children’s Hospital, Newcastle upon Tyne and is also running at four other clinical centres.

Despite great progress in the treatment of childhood leukaemia, approximately 100 children with leukaemia under the age of 15 die each year in the UK. Leukaemia that has returned or is resistant to current treatments remains one of the key causes of death from childhood cancer. Cancer is the second most common cause of death in childhood.

AT9283 looks promising in laboratory studies and has been tested in a small number of adults (solid tumours and haematological malignancies) and children and adolescents with solid tumours. This trial will assist in establishing the correct drug dose and investigate if it can treat children and adolescents with leukaemia.

Chief investigator Professor Josef Vormoor, said: “It’s devastating to have to tell parents of a child with leukaemia that the disease has returned. Or that it’s unlikely their child can be treated with existing drugs.

“So I’m incredibly excited about the launch of this trial, to see if a new drug can treat the disease, when a child has stopped responding to current treatments."  

AT9283 blocks the activity of a group of proteins called aurora kinases which control cell growth. Blocking these proteins can stop cancer cells’ ability to grow.
Around 1,500 children are diagnosed with cancer each year in the UK, with leukaemia, the most common childhood cancer accounting for around a third (31 per cent) of all cases.
The trial is funded, managed and sponsored by the charity’s Drug Development Office (DDO) and the drug is provided by Astex Pharmaceuticals.
Dr Nigel Blackburn, director of drug development at Cancer Research UK’s Drug Development Office, said: “We’ve made amazing progress in the treatment of childhood cancers: In the 1960s, only around a quarter of children with cancer survived. Today, three quarters survive. But there is much more to do.
“There’s an urgent need to develop new treatments for young people with leukaemia. The launch of this first trial of a completely new treatment for childhood leukaemia is incredible news and we’ll be watching the results with great interest.”
Cancer Research UK spent nearly £9 million last year on research into children’s cancers.

For more information on the trial, please visit www.cancerhelp.org.uk or call the Cancer Research UK cancer information nurses on 0808 800 4040.

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Potential new way to treat childhood leukaemia identified

Monday 5 September 2011

An international team of scientists has discovered a potential new treatment target for T-cell acute lymphoblastic leukaemia (T-ALL), according to work published in Nature Genetics.

The team also showed that existing drugs which affect this target can kill T-ALL cells in the lab.

T-ALL mostly affects children. It is a cancer of cells of the immune system called T-cells.

The disease is triggered by faults in the genes that control T-cells.

Researchers already knew that a protein on the surface of T-cells - called interleukin-7 receptor and made by the IL7R gene - may be involved in the disease. To find out more, they looked in detail at the IL7R gene in leukaemia samples taken from 201 patients.

Nine per cent of the samples had some kind of fault in their IL7R gene. The researchers also found that the faults caused non-stop, uncontrolled growth in the number of T-cells. Uncontrolled cell growth is a key driver of cancer.

By identifying the mutations, more efficient therapies may now be developed to target the disease. Scientists also demonstrated that a number of currently available drugs can halt the effect of the faults, and kill cancer cells in the lab, opening up opportunities for future clinical trials.

Lead researcher Joao T. Barata said: "We discovered that the interleukin-7 receptor, which is essential for proper T-cell development, may also have a "dark side", acting as a Mr. Hyde of sorts.

"In particular, we found that certain mutations in this gene are involved in paediatric T-cell acute lymphoblastic leukaemia and characterised how they act.

"Our observations allowed us to identify potential therapeutic weapons against these tumours."

Oliver Childs, senior science information officer at Cancer Research UK, said: "Although there has been tremendous progress in the treatment of T-ALL, more needs to be done, particularly for those patients who relapse. So it's encouraging to see that potential new treatment targets continue to be found through research.

"It will be exciting if these early results in cancer cells are mirrored in patients, but that may be several years away."

Copyright Press Association 2011

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Scientists uncover basis for drug resistance in common childhood cancer

Friday 20 May 2011

US scientists say they have worked out why acute lymphoblastic leukaemia (ALL) - the most common form of childhood cancer - can come back after treatment.

A research team at the University of California, San Francisco (UCSF), discovered that a protein called BCL6 helps to protect ALL cells against treatment with tyrosine kinase inhibitor (TKI) drugs such as imatinib (Glivec).

Although these drugs have changed the outlook for children and adults in recent years, in some cases treatment stops working and the cancer returns. This is thought to happen because TKI drugs don't destroy the leukaemia stem cells that can 'refuel' the disease.

The researchers, whose findings are published in the journal Nature, looked at 22,000 genes in ALL cells to see whether any were switched on or off when treated with TKI drugs.

They noticed that levels of the BCL6 protein rose significantly following treatment. BCL6 was already known to be active in other cancers, such as lymphoma, but this is the first study to link it to leukaemia.

Further experiments revealed that BCL6 was helping to keep cancer cells alive following TKI treatment by switching off a 'suicide' gene called p53, which normally causes faulty or cancerous cells to die. In particular, BCL6 helps to preserve the leukaemia stem cells that can 'regrow' the cancer.

The researchers then showed that by blocking the activity of BCL6 with an experimental drug in mice with leukaemia, they were able to significantly increase the effectiveness of imatinib treatment and improve survival. They saw the same results when they combined the BCL6-blocking drug with nilotinib, a more potent TKI drug.

This research is only at an early stage, but it suggests that BCL6 may provide a target for the development of new therapies that boost the effectiveness of treatment for ALL and improve long-term survival.

Senior author Dr Markus Muschen, professor of laboratory medicine at UCSF, said that BCL6 acts "like an emergency mechanism, whereby tumour cells try to evade drug treatment".

Dr Kat Arney, science information manager at Cancer Research UK, said: "These new results are exciting and could make a significant impact on the treatment of this type of leukaemia in the future. Although this research is only in the lab at the moment, we hope it will move quickly towards clinical trials in patients."

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Trial results show dramatically improved survival for relapsed childhood leukaemia

Saturday 4 December 2010

Cancer Research UK Press Release

A new treatment increases survival to almost 70 per cent for children whose acute lymphoblastic leukaemia (ALL) returns, according to the results of a trial published online in the Lancet today (Saturday)1.

The results of the trial – funded by Cancer Research UK and Leukaemia & Lymphoma Research2 - were so promising that now all children with relapsed ALL are being offered the trial drug Mitoxantrone.

Two hundred and sixteen children across the UK, Australia and New Zealand took part in the trial, 111 were given the standard treatment Idarubicin and 105 were given Mitoxantrone.

After three years, 69 per cent of children given Mitoxantrone had survived the disease, compared to 45 per cent of those given Idarubicin.

Professor Vaskar Saha, a Cancer Research UK paediatric oncologist based at the Paterson Institute in Manchester, said: “These striking results show just what a powerful drug Mitoxantrone is in treating children whose leukaemia has returned, offering hope to many families across the country.”

The significant increase in survival seen in this trial has resulted in Mitoxantrone being offered to all children with relapsed ALL since 2008. As well as improving survival, children given Mitoxantrone also experienced fewer side effects.

Over the last 30 years the number of children who have survived ALL has risen from 50 to over 80 per cent but similar improvements have not been seen in children whose cancer returns. It remains the leading cause of cancer death in children and survival for children whose leukaemia returns had until now remained constant at around 50 per cent.

Professor Saha added: “As a result of this trial, Mitoxantrone is now the standard treatment for relapsed ALL, and is having a significant impact on the number of children who beat the disease worldwide. This is the first time that a trial in ALL has been stopped so early after one drug had such clear benefits for patients.”

The news comes a month after Cancer Research UK launched their annual Little Stars Awards. Now in their eighth year, the Little Star Awards recognise the courage of children who have encountered cancer and are backed by a host of celebrities including singer Leona Lewis and footballer Ryan Giggs.

Unlike many other children’s awards, there is no judging panel because Cancer Research UK and TK Maxx believe each and every child who confronts cancer is special.

Kate Law, director of clinical research at Cancer Research UK, said: “These exciting results highlight the impact that research is continuing to have to help more children beat the disease. Cancer Research UK is the largest funder of research and trials into childhood cancers in the UK. Today, thanks to research like this, more than three quarters of children beat cancer, compared to a quarter in the 1960s.”

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Scientists identify genetic variations that affect childhood leukaemia risk

Wednesday 19 August 2009

Two new studies, including one by scientists at the UK's Institute of Cancer Research (ICR), have uncovered a number of inherited genetic variations that increase children's risk of developing acute lymphoblastic leukaemia (ALL), the most common form of cancer in children.

Scientists at the ICR previously identified mutations linked to ALL that occur during development in the womb, as well as other changes that occur after birth.

But this is the first time inherited risk factors have been identified, although the researchers noted that ALL does not appear to run in families.

The studies, which both appear in the journal Nature Genetics, were possible thanks to new technologies that allow the entire genetic makeup of ALL patients to be compared against healthy people so that any differences can be identified.

In their study, UK scientists found differences in three genes - IKZF1, ARID5B and CEBPE - each of which individually increased the likelihood of its carrier developing ALL by between 30 and 60 per cent.

The genes have been implicated in the development of white blood cells called lymphocytes, which are altered in ALL.

Professor Richard Houlston, head of the ICR's Molecular and Population Genetic Team and a Cancer Research UK grantee, said: "These findings provide the first evidence that genetic makeup plays a major role in the risk of ALL and insight into how the disease develops."

Co-investigator Professor Mel Greaves, chairman of the ICR's Section of Haemato-Oncology, added: "This is a very significant advance in our understanding of the complex process by which children develop leukaemia.

"The new results should not be taken, by parents or the public at large, to mean that children develop leukaemia because of an accident of inheritance. Genetic risk factors are just one component of cause.

"Finding the triggering exposures still remains a focus of intense effort, particularly with respect to possible future prevention."

In the second study, which was carried out by researchers at St Jude Children's Research Hospital in the US, 18 separate genetic variations were identified - two of which occurred in one of the genes arising from the UK study - ARID5B - and one in another - IKZF1.

The US scientists estimate that these two genes were involved in just over a third of ALL cases and note that one of them may help to predict an individual's response to treatment.

Senior author Dr Mary Relling, pharmaceutical sciences chair at St Jude, explained that the same inherited variation in ARID5B also affects the effectiveness of chemotherapy drug methotrexate in leukaemia cells.

"It accumulates better," she revealed. "That allows us to use a lower dose and still cure the leukaemia.

"These findings may identify a new marker that could be used to help decide on doses of methotrexate in patients with varying ARID5B status."

Oliver Childs, senior science information officer at Cancer Research UK, commented: "Scientists still don't know what causes most cases of leukaemia, but this fascinating work shows how a child's genes can help influence their risk of developing the disease.

"Large-scale genetic research like this opens up many interesting scientific avenues to explore. The challenge ahead for Cancer Research UK and other organisations is to apply this new genetic knowledge to help gain further insights into this type of leukaemia."

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Researchers suggest playgroups could be linked to lower leukaemia risk

Tuesday 6 May 2008

A new study suggests that children who attend playgroups may be less likely to develop the most common type of leukaemia. But a Cancer Research UK scientist said that a better understanding of the phenomenon was needed before advice could be given to parents.

Researchers at the University of California, Berkeley, analysed 14 published studies which had looked at the link between playgroup attendance and acute lymphoblastic leukaemia (ALL), which accounts for more than 80 per cent of cases of the disease.

The combined studies contained data on 6,108 children with leukaemia and a further 13,704 who were cancer-free, including information on their day care and playgroup attendance.

Twelve of the 14 studies found evidence that interaction with other children provides some protection against leukaemia, while two found no effect.

The study lends weight to the theory that children having regular contact with other children leads to them developing minor infections, which in turn affects the immune system in a way that makes leukaemia less likely.

Lead researcher Dr Patricia Buffler, professor of epidemiology at the School of Public Health of the University of California, Berkeley, said: "Combining the results from these studies together provided us with more confidence that the protective effect is real. Analysing the evidence in this way gives a more reliable answer to the question and a more precise estimate of the magnitude of the effect.

"Our analysis concluded that children who attended day care or play groups had about a 30 per cent lower risk of developing leukaemia than those who did not. Combined results for studies of day care attendance specifically before the age of one or two showed a similarly reduced risk," she revealed.

The findings were presented at the Children with Leukaemia Causes and Prevention of Childhood Leukaemia Conference in London on April 29th.

Professor Jillian Birch, director of Cancer Research UK's Paediatric and Familial Cancer Research Group at the University of Manchester, revealed that childhood cancers are rare, affecting around one in 500 children before the age of 15.

"Many studies have found evidence for a link between infection and childhood leukaemia, but exactly how infection affects a child's risk of developing the disease still remains unclear," she said.

"Until we have conclusive evidence on the risk factors for childhood leukaemia and an understanding of a mechanism behind its link with infection, it's too early to make recommendations on how to avoid this relatively rare disease."

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Sparkling Little Star Chloe is the Pride of Britain

Monday 8 October 2007

Cancer Research UK Press Release

Schoolgirl Chloe Gambrill has won a prestigious national award for her dedication to raising money for Cancer Research UK.

Chloe, one of the charity's "Little Stars", has been named Daily Mirror Pride of Britain Fundraiser of the Year and will receive her award at a glittering ceremony tomorrow night (Tues Oct 9).

Prince Charles and Prime Minister Gordon Brown will lead the tributes to the outstanding achievements of the award winners in the ceremony to be screened on ITV on Wednesday night (Oct 10).

Stars saluting the unsung heroes will include: JK Rowling, Harry Potter star Daniel Radcliffe, Ewan McGregor, Peter Kay, Ant and Dec, Stephen Fry, Dame Shirley Bassey, Simon Cowell, Jamie Oliver, Sir David Jason and Little Britain's Matt Lucas and David Walliams.

Sportsmen Lewis Hamilton, Wayne Rooney and England captain John Terry will also be there to hear the stories of breathtaking heroism and courage.

Chloe, nine, beat thousands of nominees to win the award which recognises not so much the amount of money she raised but the courage, spirit and determination it took her to raise it.

Two years ago, when she was six, Chloe, from Ramsgate, Kent, signed up to take part in the Cancer Research UK Race for Life.

She wanted to run in honour of her beloved nannie Wendy Parrish who had died of breast cancer a year earlier, aged 56. Chloe and her family had no idea that just a few weeks later she would be diagnosed with acute lymphoblastic leukaemia.

Despite starting an intensive course of chemotherapy and having an operation just three days before the race, Chloe was determined to take part.

She was so weak she collapsed part way round the course but refused to give up and get into a waiting ambulance. She was worried if she did not cross the finishing line she would lose her £100 sponsorship money.

Chloe's mum Kelly said: "When she collapsed, she was devastated. She laid in my arms begging me not to make her go back to the ambulance.

"She had already collected the sponsorship money and didn’t want to let anyone down. It seems like such a small amount but it was really important to her."

Kelly, along with Chloe's dad Darren and her older brother Charlie, now 11, took turns to carry her around the course and helped her walk over the finish line.

"We wanted to do the Race for Life in honour of my mum and to raise money for more research. Little did we know that five weeks before the race, Chloe would be diagnosed with cancer herself. It made it even more poignant.

"It's hard to put into words what it was like watching her so terribly ill, putting herself through this for her nannie.

"She was very close to her nannie. She was a huge part of both of my children's lives and Chloe was going to do it for her come what may."

Chloe is now in remission after 27 months of gruelling treatment including intravenous chemotherapy which made her hair fall out twice. She was regularly too weak to go to school, spent time in a wheelchair, suffered constant nausea and headaches and pain so severe she was given morphine.

Yet throughout her treatment Chloe showed the same determination to live a normal life as she did in the Race for Life.

She did her ballet exams, took part in dance shows and completed a sponsored swim to raise money for the Queen Elizabeth Hospital in Margate where she was often treated.

This year Chloe was able to return to the Race for Life as a guest of honour at the Isle of Thanet race. She took part and raised £850. Next year she hopes to raise more than £1,000.

Kelly said: "It's never been a huge amount of money but Chloe is always determined to do her bit."

She added: "We have always been amazed by the way Chloe has coped with leukaemia and now we are so proud. This is a huge accolade for her and it's wonderful for something so positive to come from her illness."

Chloe is one of Cancer Research UK's "Little Stars" - an award presented to children who have had cancer but continue to sparkle.

Kelly added: "If it wasn't for the kind of work Cancer Research UK does, Chloe might not be here today. We lost my mum but we had six extra years following her diagnosis. If she had been diagnosed ten years before that, we would probably not have had that extra time. Steps forward are being made all the time. That's why it is so important to support the work the charity is doing and take part in events like Race for Life - every step can help save a life."

Chloe and the other Pride of Britain winners can be seen receiving their awards at 9pm on ITV 1 on October 10. For more details visit www.prideofbritain.com.

For more information about the Cancer Research UK Race for Life, sponsored by Tesco, visit: www.raceforlife.org or call the hotline on 08705 134 314.

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Experimental MS drug may also treat leukaemia

Friday 31 August 2007

A drug currently being tested as a treatment for multiple sclerosis may one day prove useful in treating certain forms of leukaemia as well, researchers have found.

In early-stage tests, the drug, called fingolimod, was found to prevent the development of advanced chronic myelogenous leukaemia (CML) and acute lymphocytic leukaemia (ALL) in mice, and also killed human CML and ALL cells that had been grown in the laboratory.

Researchers from the Ohio State University Comprehensive Cancer Centre found that when they gave the drug to 39 mice with the two forms of leukaemia, 90 per cent were still alive after six months.

In contrast, the majority of the 39 control mice - which were not given the drug - died within four weeks of the start of the trial.

The researchers hope that, if further trials prove successful, the drug may one day be used to treat patients with these forms of leukaemia, particularly those who are resistant to current treatment options imatinib (Gleevec) and dasatinib (Sprycel).

Co-author Guido Marcucci, oncologist and associate professor of internal medicine, commented: "This novel agent represents a promising new strategy for treating CML that is resistant to imatinib and related targeted agents.

"These findings also suggest that it will be an important contribution to a new therapeutic approach to CML that considers combinations of molecular targeting compounds."

The drug works by reactivating a protein called PP2A, which is often faulty in leukaemia cells. PP2A normally protects against cancer by causing them to self-destruct when damaged.

Publishing their findings in the Journal of Clinical Investigation, Danilo Perrotti, principal investigator and assistant professor of molecular virology, immunology and medical genetics, revealed that the drug did not affect healthy cells and even worked in leukaemia cells taken from patients who were resistant to the treatments imatinib and dasatinib.

"If this is verified in future studies, it means that this drug might help patients who do not respond to other therapies," Dr Perrotti said.

He added that the findings "support the use of this PP2A activator as a novel therapeutic approach in these particular leukaemias and, perhaps, in other cancers that involve the functional loss of PP2A activity".

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Study links inherited genes, leukaemia drug toxicity

Monday 14 May 2007

A study has revealed that inherited variations in certain genes can affect the likelihood that children with leukaemia will be susceptible to the toxic side-effects of chemotherapy.

The side-effects experienced by some patients with acute lymphoblastic leukaemia (ALL) can be life-threatening and disrupt the delivery of treatment, increasing the risk of relapse.

Dr Mary Relling, senior author and chair of the pharmaceutical sciences department at St Jude Children's Research Hospital, said that the finding could therefore help to individualise chemotherapy in the treatment of ALL and cut the number of patients experiencing these side-effects.

"Such individualised therapy would eliminate the time-consuming trial-and-error approach to finding the right dose for a patient," Dr Relling explained.

"When the results of our findings are translated into routine clinical care, we should see less toxicity among children being treated for ALL."

The researchers, who have published their findings in the journal Blood, extracted the DNA from the healthy white blood cells of 240 patients and looked for 16 specific gene variations (polymorphisms) which are known to influence an individual's response to drugs.

They found that some of the 16 polymorphisms were linked to toxic side-effects in different stages of ALL treatment, while others caused more than one type of toxicity.

Dr Rochelle Long, director of the National Institutes of Health Pharmacogenetics Research Network, commented: "Scientists at St Jude and elsewhere have dramatically improved survival rates from childhood leukaemia, but it's still challenging to find the right dose for each patient.

"By finding specific genetic variations linked to how individual patients respond to therapy, this work will make medicines safer and more effective for everyone."

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Doctors warn of Gleevec heart risks

Tuesday 25 July 2006

Gleevec, the drug which can turn some forms of leukaemia into chronic but treatable conditions, may cause heart damage in a small minority of patients.

Doctors from the US Jefferson Medical College in Philadelphia added that other similar drugs could also present some risk.

However, Cancer Research UK's Dr Laura-Jane Armstrong noted that the risks found were small relative to the seriousness of leukaemia.

"This recent study shows that Gleevec is associated with some heart problems," she said.

"But these effects are only seen in a small number of patients and further analysis is required to assess the degree of risk. "It is worth noting that other cancer drugs, including targeted therapies such as Herceptin, also carry some risk of heart problems; but they are still used, as the benefits of treating the cancer far outweigh the heart risks.

"This study will better inform doctors of the potential risks, and will ultimately improve care for patients."

The research, carried out in mice and on human heart cells cultivated in a laboratory, came after ten patients suffered heart failure after being treated with Gleevec for leukaemia.

"We found that the molecular target of the drug, the Abelson tyrosine kinase (ABL) protein, serves a maintenance function in cardiac muscle cells and is necessary for their health," said lead researcher Dr Thomas Force.

"While the cancer is treated effectively, there will be some percentage of patients who could experience significant left ventricular dysfunction and even heart failure from this.

"Gleevec is a wonderful drug and patients with these diseases need to be on it.

"We're trying to call attention to the fact that Gleevec and other similar drugs coming along could have significant side effects on the heart and clinicians need to be aware of this."

The ten patients who developed heart problems during clinical trials of Gleevec had no previous symptoms of heart trouble.

Other drugs like Gleevec, collectively known as 'tyronise kinase inhibitors', could have the potential to cause a similar effect, said Dr Force, but identifying the problem was a first step toward eliminating it in further generations of the drugs.

"We've learned something about the biology of the heart," he added.

"ABL is important for cardiomyocyte health. We also can learn something about how to stay away from these targets that are important and optimize the drugs."

The study is published in the Journal Nature Medicine.

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Cancer risk to children of having older parents

Sunday 26 January 2003

Cancer Research UK Press Release

Older parents are at significantly increased risk of having a child with the most common form of leukaemia, Cancer Research UK reveals.

A study of over 3,000 cases of acute lymphoblastic leukaemia (ALL) - which accounts for around a quarter of all childhood cancers - suggests children born to older mothers and fathers have an increased risk of developing the disease.

In a separate finding, researchers also confirmed that first-born children have a higher risk of ALL than later siblings.

Scientists at the Government-funded Childhood Cancer Research Group in Oxford identified over 10,000 cases of children's cancer from the British National Registry of Childhood Tumours. The registry is maintained in collaboration with the UK Children's Cancer Study Group (UKCCSG), which is funded mainly by Cancer Research UK.

Researchers compared the children on the registry with a similar sample of healthy children, in order to analyse factors which might have contributed to their cancer risk.

Children with ALL were more often born of older parents than would be expected, even when researchers took into account the fact that older mothers are more likely to have a child with Down Syndrome, a condition which is associated with increased risk of leukaemia. A mother between the ages of 35 and 39 was 30 per cent more likely to have a child with the disease than one aged 25 to 29, with the additional risk rising to 88 per cent for mothers of 40 or over.

Researchers observed a similar pattern in fathers, though they tended to be a little older, reflecting the pattern of parental ages in the general population. Since the age of one partner is related to the age of the other, researchers were unable to say whether the increased leukaemia risk was linked to maternal or paternal age, or to both.

Dr Gerald Draper, Honorary Senior Research Fellow at the Childhood Cancer Research Group, says: "We know that some rare inherited genetic conditions can increase the risk of developing leukaemia and our research suggests the risk of inheriting such conditions is higher when parents are older. Presumably, genetic damage is more likely to be found in the eggs and the sperm-forming cells as they age."

Researchers also made a second, equally interesting finding. In their study, a family's first born was significantly more likely to develop ALL than later children, with each subsequent child at lower risk of the disease. This result was statistically strong and separate from the effect produced by increasing parental age.

Firstborns may be less likely to be exposed to infections in early life. Some scientists believe that such early exposure can prime the immune system against the possibility that later infections, in a very small number of cases, may lead to leukaemia. Firstborn children may miss out on this protective effect.

Dr Draper again: "Second and third children often catch various infections from their older brothers and sisters - and in some ways this may do them good. We think our study highlighted two separate effects on the risk of leukaemia, one perhaps related to the ageing of sperm and eggs and the other related to exposure to infection."

Sir Paul Nurse, Chief Executive of Cancer Research UK, says: "Learning about the causes of childhood cancer is vital if we're to make progress towards new ways of prevention or treatment.

"By providing new insights into the most common form of childhood leukaemia, this research has taken us a step closer to a comprehensive understanding of the disease."

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Nursery attendance may reduce the risk of childhood leukaemia

Tuesday 7 May 2002

Cancer Research UK Press Release

Toddlers that attend nursery may have a reduced risk of developing childhood leukaemia, according to a new study published in the British Journal of Cancer¹.

US researchers believe that children who are exposed to infection early and often may have a reduced chance of developing acute lymphoblastic leukaemia (ALL) because their immune system is stimulated to tackle infection at an early age.

Scientists think that childhood leukaemia could be caused by a rare immune response to common infections. Delaying a child's exposure to infection may result in an underdeveloped immune system that produces cancerous cells in response to the barrage of infections a child faces later in life.

Scientists from the Northern California Childhood Leukaemia Study looked at nursery attendance as an indicator of a child's exposure to common infections.

They analysed 140 children, aged 1-14 years, who were diagnosed between 1995 and 1999 with ALL - a type of leukaemia that results from the accumulation of abnormal white blood cells in the body.

These were compared to a group of children randomly selected from the California birth registry. Detailed data on nursery attendance was collected through questionnaires and interviews with the child's guardian.

Researchers carried out statistical analyses to compare the two groups to see if there was a relationship between nursery attendance and this childhood leukaemia.

They found that extensive contact with other children in a nursery setting is associated with a reduced risk of ALL. Starting nursery at a younger age, attending for a longer duration and having contact with a high number of children all contributed to a reduced risk of the disease.

Professor Patricia Buffler, principal investigator of the Northern California Childhood Leukaemia Study, says: "As well as attending nursery there are many ways in which the immune system can receive developmental stimulation, such as vaccination and exposure to siblings and friends. Our study contributes to the idea that isolation from common infections can increase the risk of childhood leukaemia."

Researchers think that delaying a child's exposure to infections may mean the immune system does not fully mature until the child is older.

When a child with an underdeveloped immune system is eventually exposed to infection he may respond abnormally by producing defective white blood cells that do not fight the infection but build up and may result in leukaemia.

Scientists believe that some children are born with an increased risk of ALL and this, combined with delayed exposure to infection, may lead to the production of defective white blood cells.

Study author Dr Xiaomei Ma says: "The results are from the first phase of an ongoing study. We anticipate that later studies will confirm the association between delayed exposure to infection and childhood leukaemia and eventually lead to effective prevention strategies."

Professor Buffler says: "While our results strongly support the importance of the timing of infections in the development of childhood leukaemia, we are not able to distinguish whether a particular infection or a number of common infections are involved."

Sir Paul Nurse, Interim Chief Executive of Cancer Research UK, says: "This research adds to the increasing evidence that infections play a role in some cancers, the nature of which is still unknown.

"Further investigation into exposure to infection with larger numbers of children should help us to identify the role of the immune system in childhood leukaemia and may lead to new ways to prevent the disease. Cancer Research UK is currently funding the UK National Childhood Cancer Study which is looking at the link between infections and leukaemia in over a thousand children."

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1. British Journal of Cancer86 (9)

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