Hong Kong researchers make breakthrough discovery in identifying child leukaemia patients at greater risk of relapse
- Children with acute lymphoblastic leukaemia found to be twice as likely to relapse if bone marrow samples have CD9 protein present
- ‘We hope the presence of CD9 can be an identifier of treatment failure and lower the risk of relapse, improving survival rates,’ expert says
The CD9 protein, found on the surface of several cell types, has been associated with cancer progression.
ALL, which accounts for almost a third of all cancers diagnosed in children, is the most common type in Hong Kong, with about 50 new patients every year.
Treatment at present includes chemotherapy but more severe cases require bone marrow transplants or even gene therapy.
The study analysed information collected on 3,781 children in 20 hospitals in Hong Kong and mainland China between 2015 and 2019, Li Chi-kong, a research professor at the university’s department of paediatrics, said.
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The study, the world’s largest on the relationship between the CD9 protein and relapse among child leukaemia patients, was published in the leading medical journal Leukemia last November.
“We hope the presence of CD9 can be an identifier of treatment failure and lower the risk of relapse, improving survival rates,” Li said.
He added the city’s child leukaemia patients were at present categorised into low-, medium- and high-risk groups, with different intensities of treatments being prescribed depending on factors, such as age, white blood cell count, genetics and response to early treatment.
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Although the survival rate among children with leukaemia had significantly increased by 80 per cent over the past century, making it one of the most curable cancers, Li said the risk of relapse could reach 28.2 per cent in high-risk groups.
Assistant professor Leung Kam-tong of the university’s paediatrics department said medium- and high-risk children who carried the CD9 protein saw a 23.1 per cent relapse rate, compared with 10.5 per cent among children in the same groups who did not have the protein.
“When we identify that the patient tests positive for CD9, we can stratify them at the beginning into the high-risk group and use a higher intensity of treatment,” he said.
Researchers said they hoped city hospitals could introduce CD9 testing into routine diagnostic examinations by next year, as well as include it as a factor for how patients were classified into risk groups and the type of treatment they received.
Li said that, with their network of hospitals on the mainland, Hong Kong researchers were at an advantage because they could collect a huge amount of information that centres in the United States or Europe might not have access to.
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“Our nation has many patients, but in the past the data was not collated,” Li said.
“In recent years, we have been collaborating with our huge network and standardised our research methods.
“We hope to produce more unprecedented studies and promote our findings worldwide.”
Albert Martin Li, chairman of the paediatrics department and director of the Hong Kong Hub of Paediatric Excellence, said that the study team hoped to make a “paradigm shift” in how child leukaemia was treated across the world.
“The ultimate goal is to make child leukemia’s cure rate 100 per cent, so we are not losing a single child to leukaemia,” he said.
