Research Summary

Acute Lymphoblastic Leukemia of Childhood : Enhancing Outcomes Nationally

There are two aims included in the research programme. The first one is to standardize therapy for children with acute lymphoblastic leukaemia (ALL) in India. The aim is to run national, multicenter, randomized clinical trials (titled ICICLE 2014) from Tata Translational Cancer Research Center to achieve an event free survival of >75% at the end of 5 years. Therapy will be risk stratified using molecular biomarkers for minimal residual detection (MRD). Development of a remote entry clinical trials database, which will be used as a model for other cancer trials, is also planned. The second aim is to develop prognostic biomarkers for childhood ALL with a systems medicine approach. The patients treated on ICICLE will be genetically characterized at diagnosis to allow risk stratification and have disease clearance measured molecularly using flow cytometry (MRD). Comparison of deep sequencing of Ig/TCR rearrangements with flow cytometry in MRD estimation in ICICLE will be performed. Deep sequencing will also be used to identify potential predictive and pharmacological biomarkers and compare with cytogenetic and other genetic analysis. Finally a panel of biomarkers will be developed for rapid risk stratification, validation and potential commercialization. The techniques will be extended to other cancers as well. Dr Saha will be partnering with AIIMS and Rajiv Gandhi, New Delhi; TMC Mumbai; GCRI Ahmedabad; Kidwai and St John’s, Bangalore; WIA Chennai; TMC and SGCCRI, Kolkata; ACTREC Mumbai; NIBMG Kalyani; University of Manchester and Oxford Gene Technology, UK.