The multi-center clinical research team of pediatric acute lymphoblastic leukemia reported the latest results

On April 8, supported byRuijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, the National Children‘s Medical Center and Shanghai Children’s Medical Center,“2018 leukemia precision medical international working conference” was held in Shanghai. ALL (children with acute lymphoblastic leukemia) multi-center clinical research team from the National Children‘s Medical Center and Shanghai Children’s Medical Centerreported team achievements. Rush drench leukemia children 5 years of long-term survival is up nearly 10% compared to the data 10 years ago. The overall recovery is close to 90%, close to international level in developed regions. At the same time, the study found a number of major causes of disease recurrence. This conference brought together leading experts to discuss “card neck” factors of cancer diagnosis and treatment, leukemia standardized diagnosis and treatment, precision medical new technology application, as well as registration system of health insurance payment and disease management system. 

The party central committee, the state council and the national health and health commission have always attached great importance to the diagnosis and treatment of leukemia and other major diseases. According to the CDC Shanghai cancer report submitted to the system, one in 100000 children under the age of 15, 4.7 people with leukemia, on the basis of calculated the new children leukemia patients about 14000 people a year or so, leukemia has become one of major diseases endangering children‘s health. 

Shanghai Children’s Medical Center was established in 2005, from the first domestic leukemia multi-center collaborative SCMC - ALL2005 scheme. After 10 years exploration and experience accumulation, and by the national children‘s medical center, Shanghai Children’s Medical Center continues to cooperate in a new round of multicenter and starts the CCCG - ALL2015 scheme (acute drench leukemia clinical diagnosis and treatment scheme), to have covered 20 provinces and cities all over the country (including Hong Kong). In addition, CCCG-ALL2015 program, as the first registered multi-center randomized controlled clinical trial for leukemia in China, has accumulated clinical data of more than 4,200 patients enrolled in the group in the past three years. The scheme is for the international children‘s cancer authority mentioned children’s research hospital. Pei AcademicianZhengkang got the VIVA (Hong Kong) children‘s cancer foundation funding and carried out the standard of Chinese children ALL clinical research to make the high quality of the national children’s leukemia clinical research standardization, for our children to demonstrate ALL standardized diagnosis and treatment. The project director, Tang Jingyan from Shanghai Children‘s Medical center saidas potentially the strict quality control in ALL clinical research, CCCG - ALL2015 scheme was in addition to the regular group within the transverse longitudinal verification. It also introduced the third party inspection, microscopic residual disease (MRD) quality inspection. It was strict careful to every real cases and data accuracy as a process. 

The phased results were satisfactory. The disease-free survival rate of children with acute drenching leukemia is also significantly higher than it was 10 years ago. Currently, the three-year disease-free survival rate and survival rate of the 2015 program are 87 percent and 94 percent respectively. Found that increasing the door amino acid enzyme dosage to be effective in preventing myeloid leukemia relapse, PRPS1 gene mutation is one of important reasons of recurrence of ALL and anemia caused by chemotherapy of ARHGEF12 gene polymorphism and related extremely meaningful research results, etc. She also suggests ALL mature multi-center collaborative pattern (urgent further extended to other types of leukemia and has not yet establish a multi-center collaborative areas, brings new hope for more children and their families. 

In terms of technology, the multi-center collaborative group will introduce molecular diagnosis of hereditary hematologic diseases based on NGS to clarify the classification of leukemia, so as to carry out more accurate treatment. Relapse is the leading cause of death from childhood leukemia. Shanghai Children’s Medical Center was also at the same time using the second generation sequencing technology to establish more accurate and more sensitive to tiny residual lesion detection method, the microscopic residual disease (MRD) detection levels down to 10-6 categories, which will further test the effectiveness of the treatment. 

The first national expert committee on childhood leukemia will be established. The committee will play a role of experts think tank, further standardization of diagnosis and treatment of diseases together: clinical diagnosis and treatment working group will be approved by scientific advisory, ethical, and process management specification and to promote clinical research of childhood leukemia; The clinical transformation task force will assess the scientific and feasibility of new technology transformation and assist and participate in clinical research on childhood leukemia through scientific consultation, statistical analysis. This will undoubtedly play an important role in guiding the operation of related projects and the standardization of process management in China. 

The expert group recommended that efforts should be made to develop a national cancer registration system for children, a clinical research registration system for childhood leukemia and a clinical research database for childhood leukemia. This not only greatly improves the timeliness, validity and accuracy of data acquisition, but also breaks the present situation of “the information island”. It is good for information fusion and data sharing “medical data”, for our country and the world of childhood leukemia diagnosis and treatment as well as its valuable guidance significance.