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Bone density treatment slows progression of leukaemia

Thursday, 10 May 2018

Researchers may have unlocked a vital key to reducing the progression of leukaemia in children, potentially prompting a change in thinking around the best way to target treatment.

In research published in the Nature journal, Leukemia, a team led by Telethon Kids Cancer Centre researcher Dr Laurence Cheung described how they had identified the mechanism of bone loss that occurred during the development of leukaemia – which, when treated, was able to reduce leukaemia progression.

Dr Cheung said the team’s study focused on the most common form of leukaemia in children, a subtype of Acute lymphoblastic leukaemia (ALL) known as pre-B ALL.

When we created a pre-clinical model replicating this kind of leukaemia, we witnessed substantial bone loss during the development of the cancer,” Dr Cheung said.

“We went back to the literature and found that more than a third of children diagnosed with pre-B ALL had symptoms of bone pain and skeletal defects at the time they were diagnosed – suggesting leukaemia cells can alter their surrounding environment.”

The researchers wanted to discover what was causing the bone loss, and identified a signal produced by the leukaemia cells which instructed cells in the microenvironment – known as osteoclasts – to eat away at the bone.

The team used a commercially available drug called zoledronic acid – already known to be safe for children and used to treat brittle bone disease – to target the cells in the microenvironment around the leukaemia cells.

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Bill Petch, CEO of the Leukaemia Foundation, said it was exciting to see zoledronic acid being explored by childhood leukaemia researchers.

“We know that zoledronic acid is currently successfully used in adult Myeloma patients to treat bone deterioration and density loss and while it has some side effects, these are known to be minimal,” he said.

“Importantly, prevention of bone loss during treatment may have significant implications for later in life. As failure to accrue appropriate bone mass during childhood may place survivors at increased risk for deficits in bone density and fracture.

“We are in a promising new age of both understanding how blood cancers develop, how they operate in the body and how best to treat them as individual diseases.

“Targeted therapies or personalised medicine for specific diseases are a big part of the paradigm shift of treatment. The Leukaemia Foundation strongly supports and encourages expediting any research of its kind.

“Working together to improve survival and quality of life for people diagnosed with a blood cancer is paramount.

“This research is in early stages and therefore more investment, research and trials are needed in this area, however it is a step forward to ultimately provide better outcomes for children diagnosed with ALL.”

The Leukaemia Foundation congratulates Telethon Kids Institute Researchers for the development of this research.