Last update on: 01/20/2009
The studies of treatment optimisation studies (TOS) have instantly paved a way to introduce new technologies of the laboratory for the patients' benefit. Many of these projects were formerly funded in the context of the EU Framework Research Programmes.
Methods of Early Diagnosis
On hand of highly sensitive methods tumour cells can be identified within leukemia as well as within solid tumours in blood and bone marrow. In order to:
- identify the degree of illness prior to treatment initiation
- serve as optimal standard of treatment effects
- identify relapse during and after treatment at a very early stage.
This improved diagnostic results in an individualised treatment adapted to the actual risk of the patient.
The Children's Cancer Research Institute has developed sensitive immunological and molecular methods of detection for different cancers (leukemia, Ewing's sarcoma, neuroblastoma) . Today, their application is standardised across Europe for leukemia. These analyses have enabled the detection of the treatment's response already nine weeks after the diagnosis, thus enabling the estimation of the risk of relapse.
This means that children with a small risk are only faced with minor treatment side effects. Children with a bad response should be given an increased chance of a cure via alternative treatments.
Bone Marrow Transplantation
For many patients the only life saving treatment .
Progenitor cells of haemotosis (so-called bone marrow stem cells), which were removed from a donor's bone marrow, are infused into a recipient, whose bone marrow and immune system have largely been destroyed by a preliminary chemotherapy. This procedure has been established as most effective in order to kill off remaining tumour cells inside the patient's body and can be employed successfully more frequently than before, due to substantial methodological improvements.
The premise for a successful transplantation is a compliance between compatibility criteria of donor and recipient. Today a database with nearly ten million potential donors facilitiates the identification of a suitable donor. A highly sensitive method, which typically analyses that lattice constant by the means of flow cytometry (FACS), is employed successfully to even perform haploid identical transplantations, those during which only half of the compatability criteria between donor and patient is present.
Blood Stem Cell Transplantation
This new procedure has proven itself, for autological stem cell transplantation (= recirculation of one's own blood stem cells into the bloodstream, especially with patients with aggressively metastising forms of cancer) as well as for the allogenic stem cell transplantation (=infusion of blood stem cells of suitable donors, eg. during not maligant but life threatening hematological or immunological diseases).
- Up until a few years ago it was customary to obtain blood stem cells from the bone marrow. However, the research results of the Children’s Cancer Research Institute have demonstrated that stem cells obtained from blood (after special preparation) have remarkably stronger growth within the recipient and are more compatible.
- This extraction of stem cells is of less risk for the donor and allows a quicker regeneration of the recipient's haematosis.
- With the help of new molecular genetic methods one can monitor the regeneration of blood cells after a transplant. Already within the first few days after the transplantation an impending rejection or an initiating relapse of the disease can be identified and those can be treated quickly.
- The first months after the transplantation are a critical time period for the patients. Due to the suppression of the immune system the compatability of the donated stem cells from the donating organism must be "learned". Up until the full regeneration of the body's immune system there is a great risk of infection. The goal of transplantation immunology is to develop procedures which satisfy both aspects.