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Precision Medicine in acute lymphoblastic leukaemia

Deb White





Professor Deb White, South Australian Health and Medical Research Institute (SAHMRI) (Adelaide).
Funding period: 2019-2022.

This project is kindly supported through the Estate of Edward Rhoades and Phil’s Dive for a Cure.

Acute lymphoblastic leukaemia (ALL) is the most common childhood cancer and remains the leading cause of non-traumatic death in children. For adolescents and young adults with ALL the therapeutic outcomes are poor. Most older adults will die of their disease. ALL is characterised by recurrent gene fusions and associated structural chromosomal abnormalities. New technologies, like Next Generation Sequencing (NGS), are now providing us with a wealth of genomic information. Applying these techniques in ALL has identified new DNA mutations in patients with ALL known to confer high-risk, however it is also identifying new subgroups and recurrent gene fusions for which biological and clinical implications remain unclear.

Professor White is the head of the Australian Centre for ALL Genomics and this project is looking to introducing a more personalised approach to care for patients with ALL by incorporating the genomic information gained through NGS into clinical care, using this genomic information to help systematically identify druggable targets and effective rational therapies. The Leukaemia Foundation’s support to this project will make NGS testing available to an additional 100 newly diagnosed patients Australia wide.

In addition to providing NGS sequencing, Prof White’s team will also investigate ALL disease invasion and penetration into the central nervous system. Create a model to investigate cooperating mutations (ie when two or more genes are often seen mutated together in ALL). Perform high throughput drug screening in order to test the sensitivity of ALL to a panel of drug agents.

Recent evidence has shown the importance of the gut microbiome and immune system. In an Australian first Professor White’s team will also investigate the effect of the gut microbiota in various stages of the disease from diagnosis, through therapy and beyond. These studies will assess the microbiomes impact on therapeutic efficacy, and to understand whether microbiota manipulation will improve outcomes for ALL patients.