Childhood Cancer

Leukemia

Childhood leukemia is a cancer that starts in the blood-forming cells in the bone marrow. Leukemia is most often found in the white blood cells; but  it can develop in other blood cell types. It is the most common form of childhood cancer and there are several types and sub-types.

Latest Leukemia grants

Gabriel Cohn, Principal Investigator
University of Vermont
POST Program Grants, Awarded 2017
Emily Haussler, Principal Investigator
Washington University School of Medicine
POST Program Grants, Awarded 2017
Tyler Galvelis, Principal Investigator
The Children's Hospital of Philadelphia
POST Program Grants, Awarded 2017

Latest Leukemia blog posts

April 28, 2017

by Trish Adkins

When a child is first diagnosed with leukemia, the goal is to force the disease into remission. The treatment protocol is long and grueling—at least 2 1/2 years of chemotherapy, lumbar punctures and clinic visits. Today, children diagnosed with the most common form of pediatric leukemia—acute lymphoblastic leukemia (ALL)—have a high cure rate. The discovery of genetic differences that can increase a child’s risk of relapse has helped some of the highest risk patients reach remission. 

But, not all children with ALL reach remission. When they relapse, the second round of treatment is much more intense than the first says Dr. Todd Druley, ALSF Scientific Advisory Board Member and Assistant Professor of Pediatrics, Developmental Biology and Genetics at Washington University.  

Dr. Druley says the reason lies within the genetic drivers of the child’s specific type of leukemia. Better outcomes and cures will be found with continued genetic studies, innovation in technology and targeted treatments.

Understanding Leukemia
A diagnosis of leukemia is suspected after a blood test and confirmed by a bone marrow biopsy. The cells that make blood reside primarily in the bone marrow and when a child has leukemia, one of those cells becomes cancerous and overruns the other healthy cells.

While most childhood leukemia diagnoses are ALL, children are also diagnosed with acute myeloid leukemia (AML), chronic lymphoblastic leukemia (CLL), chronic myeloid leukemia (CML), and juvenile myelomonocytic leukemia (JMML). The acute form of the disease will grow suddenly—meaning the leukemia is spreading rapidly and outnumbering healthy cells and a child can become very sick quickly. 

Managing Risk Factors
One of the early breakthroughs in the treatment of childhood leukemia was to better understand the genetic differences between adult and childhood forms of the disease. Now, researchers have deconstructed the disease even further, giving them the ability to manage the risk factors for newly diagnosed patients. 

“Ten years ago, we did not appreciate the genetic differences inherent to leukemia and we thought most children had a standard risk. Now, we can see the subtypes of leukemia more precisely and provide the correct intensity of treatment,” said Dr. Druley

This helps children with both low and high-risk leukemia. Children with lower risk factors can receive a less intense treatment and therefore minimize long term side effects (which can include cardiac damage, developmental delays and fertility issues). 

If a relapse occurs, doctors now have more tools to battle the disease including CAR T cell immunotherapy, which works to harness the body’s immune system to attack the cancer cells. This therapy uses a patient’s own genetically engineered T cells (an immune cell that attacks things that are foreign to the body) to attack cancer cells that have been hiding from the immune system. 

Hope in the DNA
Genetic studies have also helped doctors understand infant ALL and AML (leukemia less than 12 months of age), which has significantly lower cure rates compared to leukemia in older children. Dr. Druley’s research suggests that babies who have leukemia appear to have inherited a genetic predisposition that makes them highly susceptible to developing the disease. 

Dr. Druley’s research continues to focus on determining the genetic drivers that predispose children to cancer and how to mitigate the effects of these genetic mutations and stop cancer formation. Understanding these genetic markers can also open the door to understanding how to treat other types of childhood cancer.

Scientists have discovered the same mutations in blood cells, also exist in solid tissue tumors, which helps provide critical clues into what makes a variety of childhood cancer types tick. 

“Science is telling us that treating cancer by its tissue or origin ( blood, lung, brain, etc) is often less effective than treating the genetic type of the tumor, guiding us to tailor therapy in whole new and exciting way,” said Dr. Druley.

Read more about Dr. Druley’s research here.

 

April 27, 2017

More and more research is focused on harnessing the body’s immune system to target and destroy cancer cells. One type, known as CAR T cell immunotherapy, is offering new hope and cures to patients with relapsed acute lymphoblastic leukemia (ALL). Here’s everything you need to know about CAR T cell immunotherapy:

What is immunotherapy?
Immunotherapy recruits the body’s own immune system to identify and kill cancer cells. Cancer cells hide from the immune system—convincing the body that they belong. As a result, cancer cells can grow without interference. Immunotherapy treatments activate the individual’s immune system so it can see cancer cells among the healthy cells, stop them from growing and kill existing cancer cells. 

What are T cells?
T cells are a type of white blood cell that works with the body’s immune system to help identify and destroy foreign invaders—like a virus. T cells appear when the body identifies an infection or injury; they replicate quickly in order to attack. Once their job is complete, the T cells decrease in number. When a child has leukemia, the T cells cannot see the cancer cells and therefore, they do not go to work fighting the cancer cells, as they would a virus. 

What is the “CAR” part of CAR T cell immunotherapy?
CAR stands for “Chimeric Antigen Receptor.” This lab-created cell modification takes the blindfold off T cells, allowing them to recognize cancer cells. 

How does CAR T cell immunotherapy work?
Making a T cell “see” cancer cells begins with collecting a child’s T cells. Then, those T cells are genetically modified with the addition of the chimeric antigen receptor (that’s the CAR part). The chimeric antigen receptor allows T cells to see the cancer cells. Once the child receives the newly modified T cells, the immune system goes to work. The T cells multiply, attacking the cancer until it is gone. CAR T cells have shown remarkable success in the treatment of relapsed leukemia and have the potential to be a tool in the fight against other childhood cancers such as brain tumors and neuroblastoma. 

What are side effects of CAR T cell immunotherapy?
Modified T cells release cytokines, which are chemical messengers that help the T cells destroy foreign invaders. Sometimes, there can be a rapid release of cytokines and this can cause extremely high fevers and extreme drops in blood pressure. Several researchers have used complementary therapies to stop cytokine release syndrome and are also working to understand the genetic drivers of cytokine release syndrome. 

What potential does this have for other types of cancer?
For now, CAR T cell immunotherapy offers the most promise for leukemia. However, understanding how modified T cells attack blood cancers can lead to more discoveries on how these cells could also lead to cures for solid tissue tumors. 

Who has CAR T cell immunotherapy helped?
CAR T cell immunotherapy could offer promise for many children battling relapsed ALL. In our Spring 2017 newsletter, we shared the story of how ALSF-funded Young Investigator, Dr. Rebecca Gardner at Seattle Children’s Hospital helped a young girl reach remission for her relapsed leukemia. Read more here.

 

December 22, 2016

For those of us in the northern United States, it feels like days of sipping lemonade are far behind us during these long winter months. But, every day is a great day to support Alex’s Lemonade Stand Foundation! Leave the icy cold lemonade behind and instead, embrace the winter season!  

Curing Childhood Cancer, One Gingerbread House At a Time
One of our supporters, the Hyatt Regency Crystal City in the Virginia suburbs of Washington, DC, is helping cure childhood cancer, one gingerbread house at a time!  The Hyatt hosts a Gingerbread Challenge each year as a fun event for clients in the DC Metro. This year the employees turned the event into a fun, winter fundraiser for ALSF.

Hero mom and Hyatt employee Michelle Crabtree suggested that the event benefit ALSF. Her son Tyler was diagnosed with Pre-B acute lymphoblastic leukemia (low risk)  when he was 2 1/2. Tyler completed 3 years of treatment and  is now seven years old. The Crabtree family supports ALSF as hero ambassadors and lemonade stand hosts.  

This fun and creative event was a great way for the Hyatt to engage their clients and to help raise awareness and funds for childhood cancer research. At the event, the Hyatt set up an onsite lemonade stand, while teams worked to assemble creative, holiday gingerbread houses. Entries were posted online for public voting and the winning team (with 131 likes!) won a 2-hour reception for up to 25 guests at the Hyatt. That winning team, the Expedia Team, donated their winnings back to ALSF!  

Warming Up With Hot Cocoa
ALSF hero Matthew McDonnell decided to give his Alex’s Lemonade Stand a winter twist! The six-year-old, who has been battling Wilms’ tumor since he was three-years-old, decided to switch up the usual lemonade with hot cocoa. Matthew’s Miraculous Hot Cocoa Stand was held outside a local park in his hometown! Friends and neighbors came out and warmed up with a cup of hot cocoa while making donations to support ALSF!

Have you hosted a winter fundraiser for ALSF? Tell us about it on Facebook, Twitter or Instagram!  And don't delay, now is the perfect time to register your winter lemonade (or hot cocoa) stand!