Understanding leukaemia cells and restoring bone marrow in children with leukaemia

Laurence’s grant is co-funded by Cure Cancer, Cancer Australia Priority-driven Collaborative Cancer Research Scheme and Leukaemia Foundation.

Laurence is based at the Telethon Kids Institute and Curtin University.

The most common form of blood cancer in children is acute lymphoblastic leukaemia, known as ALL. Improvements in therapy over the past sixty years have seen cure rates improve to more than 90%, but several high-risk genetic patient subgroups have much poorer outcomes. Some of these children have less than a 40% chance of survival.

This is an area of special concern and research interest for Dr Laurence Cheung, a Senior Lecturer at Western Australia’s Curtin University and Senior Research Officer at the WA Telethon Kids Institute, which focuses on the treatment of paediatric leukaemia.

His research

“Better therapies for high-risk patients are desperately needed,” says Laurence. In this quest, in his Cure Cancer-funded research he will study the development of high-risk ALL in bone marrow and the interaction of leukaemia cells with neighbouring cells – commonly known as the leukaemia microenvironment. And he will evaluate whether restoring the healthy microenvironment can improve treatment outcomes for children with leukaemia.

The microenvironment of solid tumours has been well investigated as a factor in the progression of cancer, its resistance to therapy, spread and relapse, explains Laurence. But scientists have only recently begun to appreciate the importance of the blood cancer microenvironment.

“Over the past 20 years clinical studies have clearly shown the defective bone marrow structure and bone loss in children and infants diagnosed with leukaemia,” he says. “Yet we know little about how normal bone and bone marrow cells are involved in the start, progression and relapse of the disease.”

“My research is focused on one novel strategy which is to target cells surrounding the leukaemia cells with aims to reduce the impact of cancer and lessen the short- and long-term side effects of traditional treatments for all children diagnosed with ALL. The leukaemia microenvironment is an attractive target for novel drug therapies, especially for children with high-risk leukaemia in which dose-limiting toxicities of conventional chemotherapeutic agents have prevented further improvements.  I believe a combined approach, targeting both cancer cells and surrounding cells, will be an effective therapeutic strategy to treat patients.”

He has made real progress. Laurence and collaborators in Australia and the US have already established a preclinical model that replicates the clinical features of bone loss in children with ALL at diagnosis. This provides an avenue for researchers to understand the “communication networks” among cells in bone marrow when leukaemia develops.

In addition, the team recently completed a proof-of-concept study showing that targeting the leukaemia microenvironment can not only stop bone loss but hamper the progression of the disease. “This is a very exciting finding,” he says.

Laurence's inspiration

Laurence’s career progression has been unusual for a cancer researcher. A pharmacist by training, he originally worked as a community pharmacist in Perth for eight years, a period in which he came across parents whose kids had leukaemia. Their stories helped motivate him to change careers. He completed his PhD at the Telethon Kids Institute in the area of blood cell development and paediatric leukaemia in 2014.

Today, in addition to his research work he practises as a clinical trial governance pharmacist at Perth Children’s Hospital, and considers himself lucky to have an “all-in-one” career that involves his passions.

Cancer patients should know they’re not alone, he adds. “There are many clinicians and scientists, including me, who work tirelessly.”

With three young children, Laurence seeks quality time with his family when not at work. “I want parents whose children suffer from leukaemia to be able to do the same.”

The importance of funding

Two thousand and nineteen was a great year for him, he acknowledges. “I not only received the support from Cure Cancer, I was also named the 2019 Cancer Council Western Australia Early Career Researcher of the Year and received the STEM Early Career Research Award at Curtin University.”

But the Cure Cancer grant is the first national research funding he has received and it will significantly boost his career by forming the basis for future grant applications at a national level, he says. “I’m very grateful to Cure Cancer for providing me with this opportunity! I’m now a step closer to establishing myself as an independent researcher and can continue to make a contribution to the field of the leukaemia microenvironment.”

He believes dedication, vision and a passion to make a difference are essential requirements for success.

"Better therapies for high-risk patients are desperately needed."

Together, we can cure cancer.

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