Saving children’s lives across the globe

Leukaemia is the most common cancer in children and teenagers, and acute lymphoblastic leukaemia (ALL) is the most common type of childhood leukaemia. Research at The University of Manchester has made a significant contribution to the UK having one of the highest cure rates in childhood ALL internationally.

Global problem: a deadly form of cancer 

Acute lymphoblastic leukaemia (ALL) is a particularly rapid and aggressive form of cancer requiring immediate treatment. 

Manchester solution: breakthrough drug trials

For the last 20 years, researchers at The University of Manchester have pioneered standards by which children with ALL are treated.

The work at Manchester led to the routine use of specific drugs that are now standard in the therapy of childhood ALL in the UK and Ireland. A further clinical trial (ALLR3) designed by Vaskar Saha, Professor of Paediatric Oncology at Manchester, now forms the basis of relapse strategies worldwide for children with ALL.

Professor Saha says: “Manchester is recognised internationally as a centre for expertise in teenage and young adult cancers, and nationally as a centre for clinical studies in childhood leukaemia – which made it easy for us to find willing collaborators.

“Thanks to the scale and extent of our international partnership, The University of Manchester was able to design and run a unique trial – the largest study of its kind in the world – and the first-ever randomised international trial for relapsed ALL.”

Collaborators from countries including the Netherlands, Australia and New Zealand needed to adapt the study quickly for their patients. To facilitate this, we created an innovative bespoke remote-entry clinical trial management system, which permitted remote registration and data entry, provided decision support and standardised reporting across all recruiting centres.

Professor Saha added: “We also built translational research into the clinical trials, which allowed the identification of previously unidentified mechanisms of therapeutic failure, paving the way for novel therapeutic strategies.”

Taking research worldwide

The strategies developed for both newly diagnosed and relapsed ALL have contributed to outcome improvements in UK and internationally, most notably in affluent countries. In many other parts of the world, the outcomes for children with cancer fall behind those of the west.

In 2014, the University entered a partnership with the Tata Medical Center (TMC) in Kolkata, India to help standardise treatment for children with ALL through a national hub of cancer centres.

Since 2014 there has been an improvement in patient outcomes and in partnership with the TMC, the Tata Translational Cancer Research Centre (TTCRC) was established which incorporates a cancer biorepository, a clinical trial unit and state of the art laboratories.

The five main paediatric cancer hospitals in India have been networked, treatment protocols and processes standardised and the expertise acquired by the main centres is being rolled out to other units across India. The skills and technology developed are now being extended to explore solutions for gallbladder cancer – a rare and neglected cancer with a high incidence in India.

"We are now expanding our research to deliver better treatments and gentler cures. Universities are places of learning – and what is the purpose of learning if not to share it?” says Professor Saha.

Life-changing impacts

Direct results of our clinical trials and translational research in ALL include:

• children in the UK newly diagnosed with ALL now have a cure rate of over 85% – among the best in the world;
• outcomes for relapsed cases have improved by 10% in the UK, the Netherlands, Australia and New Zealand;
• a role has been identified for the drug mitoxantrone, which improves the outcome of all categories of relapse compared to previously used drugs;
• changes in clinical practice based on our research are now national standards of care for children with ALL in the UK and Ireland;
• various international groups have adopted key findings from the front-line trials, and the relapse protocol for childhood ALL now underpins European practice, helping save more children’s lives in more countries.

Find out more

• The University of Manchester Magazine: Taking on the challenge
• Faculty of Biology, Medicine and Health story: Changing lives and meeting need
• Read the research papers here.

Meet the researchers:

• Professor Vaskar Saha, Professor of Paediatric Oncology
• Professor Tim Eden, Emeritus Professor of Paediatric and Adolescent Oncology