Dr Gillian Horne, from the University of Glasgow, works on one of the sub-types of ALL that can often have a bad prognosis. Her research aims to identify a “fingerprint” of the Ph+ALL sub-type which can be matched to identify patients at diagnosis who may do worse. This means treatment can be tailored from diagnosis to suit the patient and that they can be monitored closely.

The Challenge:

Acute lymphoblastic leukaemia (ALL) is a type of blood cancer that affects lymphocytes, a type of white blood cell. It is an aggressive and fast-moving form of leukaemia which is most commonly found in children but also occurs in adults. Ph+ ALL (Philadelphia chromosome–positive acute lymphoblastic leukaemia) is a subtype of ALL characterised by the presence of the Philadelphia chromosome, a genetic abnormality caused by a rearrangement of chromosomes and contributing to uncontrolled growth of the cells.

The Ph+ chromosome is found in about 20-30% of  ALL cases[1] and is considered a high-risk form of ALL with worse prognosis, as patients tend to respond less well to treatment and often experience relapse. Dr Horne’s previous work has identified a sub-group of patients which does particularly badly due to the Ph+ chromosome originating in a different cell than expected. The challenge now is to find a way to better diagnose this group of patients before treatment starts.

[1] Ravandi F, Kebriaei P. Philadelphia chromosome-positive acute lymphoblastic leukemia. Hematol Oncol Clin North Am. 2009 Oct;23(5):1043-63, vi. doi: 10.1016/j.hoc.2009.07.007. PMID: 19825452; PMCID: PMC4091825.

The Research:

Imagine the bone marrow as a factory that makes blood cells. In some cases of Ph+ALL, the factory develops a fault on one of the assembly lines that makes B cells (a type of white cell). This is serious, but because the problem is limited to one line, we have good ways to fix it. In other cases, the fault starts right at the main power supply of the factory (the blood stem cells that feed all the lines). When this happens, the whole factory is affected, making the cancer much harder to treat.

Dr Horne’s research is about building better diagnostic tools to quickly spot where the fault has occurred and identify when the disease will be harder to treat, so we can send in the right “repair team” (treatment) and give patients the best chance of a cure.

Dr. Horne and her team are using advanced technology to look for a unique “fingerprint” in the disease. This “fingerprint” could help doctors predict, at the time of diagnosis, which patients are likely to do well and which may face more challenges. To achieve this, the team is recreating the disease in the lab so they can test and develop better treatments.