Projects we fund

Overview

The outcome for children and young people diagnosed with acute lymphoblastic leukaemia (CYP-ALL) has improved dramatically over the past few decades. One of the reasons for this improvement is the tailoring of treatment to each patient. This means ensuring that each patient receives the level and type of chemotherapy that matches their risk of relapse. A patient’s likelihood of relapse is determined by many different risk factors. The most important factors are the speed at which the leukaemia responds to the first course of therapy and the genetic make-up of the leukaemia. Research has shown that there are at least 25 different genetic subtypes of CYP-ALL. The current clinical trial for CYP-ALL, ALLTogether-01, uses 10 leukaemia genetic subtypes to guide treatment. For the remaining subtypes, there is a lack of robust data regarding the relationship with risk of relapse. 

Proposal

The ALLTogether-01 trial is running in 16 European countries and will recruit 8,000 patients. It opened in July 2020 and has recruited 2,000 patients already. At diagnosis each patient’s leukaemia is tested to assess if it belongs to one of the 10 treatment relevant subtypes. Over the past 5 years there has been a technical revolution with a shift from focussed testing to broad (or genome-wide) testing. As a result, standard-of-care testing now routinely detects most of the 25 different genetic subtypes in CYP-ALL. ALLTogether-01 uses a central online database to collect information essential for the trial. For genetics, this means the treatment relevant subtypes but not the additional genetic subtypes. We will design and build a bespoke secure online database and establish robust data flows to capture complex genetic data from multiple centres across the participating countries. We will then analyse the data to determine the frequency and impact of these understudied subtypes. Patients are asked specifically about future research studies including accessing medical records and data crossing borders when they are consented for the trial. We will exclude any patient who did not give appropriate consent. No patient identifiable information will be stored in the online database and access will be restricted to a small number of researchers. 

What difference will this project make?

The findings of this study will be used in future studies, namely ALLTogether-02, to tailor patients’ therapy according to the genetic subtype of their leukaemia.