Childhood Leukaemia Research Group (Halsey Lab)
Our goal is to revolutionise central nervous system directed therapy for childhood leukaemia.
Cancer is the leading cause of death for children aged 1-14 years and despite improvements in survival, leukaemia still accounts for about a quarter of these deaths. Even if cured, many survivors have significant chemotherapy side-effects resulting in late mortality, reduced academic achievement, poor quality of life and accompanying health and societal impacts.
The commonest long-term effects are adverse neurological/neurocognitive outcomes seen in 20-40% of patients with acute lymphoblastic leukaemia (ALL) 1,2.This reflects the use of neurotoxic agents to prevent ALL relapse within the central nervous system (CNS). There is an urgent need to develop more effective, and less-toxic, treatments for CNS-ALL. This is the key mission of our childhood leukaemia research group.
Our current therapies for CNS-ALL are both toxic and onerous. Treatment involves up to 26 chemotherapy injections into the CSF via spinal-tap under sedation/anaesthetic. Current tests to detect leukaemia in CSF are crude, so treatment is given to all children and young adults, without knowing how much is really needed.
Short-term side-effects include fits (affecting about 1-in-10 patients). Longer-term side-effects include reductions in intelligence, attention span and memory (affecting about 1-in-3 patients). There are likely to be many children that are overtreated and some that require more intensive treatment but currently we have no reliable way to find this out.
Another problem is that we haven’t had any new drugs for CNS-ALL for the last 60 years. This is exacerbated by the inability to measure CNS-AL accurately – so it is difficult to work out if a new drug is working without waiting a long time to see if the leukaemia comes back.
Our research aims to address the two major barriers to progress in the field:
- 1) an incomplete understanding of the key biological mechanisms underlying ALL survival in the CNS microenvironment.
- 2) a lack of clinically useful CNS-ALL diagnostic and prognostic biomarkers.
As well as this we are interested in finding out why only some children get neurotoxicity and if there are any ways we can prevent or reduce the side-effects of our current treatments for CNS leukaemia.
We have three research themes:
- Understanding the biology of CNS leukaemia to develop novel treatments
- Developing diagnostic and prognostic biomarkers for CNS leukaemia
- Reducing neurotoxicity in childhood ALL
We also love public engagement activities and try and maximise patient involvement in our research.
Patients and Funders
We would like to acknowledge the patients and families participating in our research projects and the generous support of all the funders, past and present, who make our work possible:
- Chief Scientist Office
- Glasgow Children's Hospital Charity
- Children with Cancer UK
- British Society for Haematology (BSH)
- Tenovus Scotland
- Action Medical Research
- Little Princess Trust
- Blood Cancer UK
- Children's Cancer and Leukaemia Group
- Wellcome Trust
- Universities Scotland
- The Kay Kendall Leukaemia Fund
- 1. Cheung YT, Sabin ND, Reddick WE, et al. Leukoencephalopathy and long-term neurobehavioural, neurocognitive, and brain imaging outcomes in survivors of childhood acute lymphoblastic leukaemia treated with chemotherapy: a longitudinal analysis. Lancet Haematol. 2016;3(10):e456-e466.
- 2. Halsey C, Buck G, Richards S, Vargha-Khadem F, Hill F, Gibson B. The impact of therapy for childhood acute lymphoblastic leukaemia on intelligence quotients; results of the risk-stratified randomized central nervous system treatment trial MRC UKALL XI. J Hematol Oncol. 2011;4:42.