Programme national de dépistage et prise en charge des enfants, adolescents et adultes canadiens atteints de leucémie lymphoblastique aigue Phi-like

 

Thai Hoa Tran

Centre hospitalier universitaire Sainte Justine

 

Domaine : cancer

Programme Chercheurs-boursiers cliniciens - Junior 1

Concours 2019-2020

While cure rates for childhood acute lymphoblastic leukemia (ALL) have significantly improved in the current era, relapse remains the most common cause of treatment failure and death. Teenagers and adults with ALL have a worse outcome compared to their younger counterparts. The ALL community of clinicians and researchers has been focusing on finding new cures for patients who are at the highest risk of their leukemia coming back. Advances in cancer genetics have recently made several important discoveries, such as the identification of a particular group of patients who display a "genetic signature" similar to that of Philadelphia (Ph) chromosome-positive ALL; hence, known as Philadelphia chromosome-like ALL or Ph-like ALL.  Ph-like ALL comprises approximately 15% of childhood and 25% of adult ALL. Importantly, this group has high rates of treatment failure and poor survival compared to those without the "Ph-like" signature. It has also been shown that these patients respond to a special group of chemotherapy agents called "tyrosine kinase inhibitors" (TKIs) such as dasatinib and ruxolitinib.  It is believed that combining TKIs with chemotherapy will cure most of these patients.   Several international oncology groups are developing clinical trials to identify and add TKI to chemotherapy in Ph-like ALL. 

However, routine testing for Ph-like ALL is not widely available in Canada given the complexity in identifying the "genetic signature".  Therefore, a significant proportion of Ph-like ALL patients remains undiagnosed and untreated every year. To address this gap,  my research program aims to develop a comprehensive Ph-like screening platform using novel sequencing technologies and design clinical trials to treat Ph-like ALL by incorporating the relevant TKI with chemotherapy.  My program fulfills an important yet unmet clinical need and can save many Ph-like ALL patients' lives.