For most children with cancer, chemotherapy is effective. The treatment is often necessary to combat the initial cancer and increase the child’s chances of survival. Without chemotherapy, the chance of survival is significantly lower.
Unfortunately, chemotherapy can also damage the DNA of healthy blood cells, which can lead to secondary cancers like leukemia in some children. Each year, a few children in the Netherlands develop this form of leukemia after a previous treatment. ‘With this research, we better understand how this second cancer develops, we can monitor these children better and potentially prevent it in the future,’ says principal investigator Ruben van Boxtel.
DNA changes due to chemotherapy
Research from the Van Boxtel group shows that certain changes in the DNA play a role in the development of this so-called 'therapy-related leukemia'. These findings were recently published in the renowned journal Nature Communications. First author Eline Bertrums says: ‘We have discovered that chemotherapy causes certain genetic changes that increase the risk of leukemia.’
New strategies to prevent complications
‘Our method allows us to map the genetic changes that lead to leukemia accurately,’ Bertrums explains. ‘This enables us to see exactly which changes are caused by chemotherapy and which contribute to the development of leukemia. This helps us to develop new strategies to prevent these complications, for example, by adjusting treatments to be less harmful to healthy cells.’
Specific mutations mapped
The research team used advanced techniques to study the DNA changes in blood cells of children. They compared blood samples from children with this secondary form of cancer to those from children who recovered from cancer after the first treatment. This allowed them to find specific genetic changes caused by chemotherapy.
Better monitoring and targeted treatments
Van Boxtel emphasizes the impact of the findings: ‘This research provides the opportunity to monitor children better during and after treatment. This way, we can intervene early if there are signs of leukemia, increasing the chance of successful treatment.’
He adds: ‘The insights from this research can lead to more effective cancer treatments for children, reducing the risk of severe complications. By better understanding which types of chemotherapy can contribute to the development of secondary cancer, we can develop treatments that are less harmful to healthy cells. This helps improve the survival rates and quality of life for children. Ultimately, we hope to reduce the long-term effects for children and increase their chances of a healthy and happy life.’