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research spotlight

WHEN A CURE IS NOT ENOUGH: ADDRESSING CHALLENGES IN TREATING
CHILDHOOD CANCER

The paediatric oncology team of clinicians and scientists in UMMC,
led by Professor Hany Ariffin (second from the right).
PROFESSOR DR HANY ARIFFIN cancers such as Wilms’ tumour, lymphoma
DEPARTMENT OF PAEDIATRICS and hepatoblastoma. However, these stellar
n the late 1970s, survival of children with achievements have come at a price. Many
Iacute lymphoblastic leukaemia (ALL), the childhood cancer patients survive decades
commonest childhood cancer, in UMMC was after completing treatment but experience
reported to be between 30-40% (Sinniah, 1978). premature development of chronic health
The adoption of the German BFM protocols in conditions. A phenotype of accelerated ageing
the mid-1980s with intensive chemotherapy in these survivors with co-morbidities such
and prophylactic cranial irradiation increased as ischemic heart disease, diabetes mellitus,
overall survival (OS) to 56% (Ng, 2000). In 2003, chronic renal failure, and frailty in their early
with the founding of the Malaysia-Singapore forties is particularly striking (Bhakta, 2017).
(MASPORE) Leukemia Study Group, the Clearly, paediatric oncologists have a central
MASPORE-ALL2003 protocol was launched, role in leading research to elucidate the
incorporating cytogenetics and PCR-based effects of cancer and its treatment on growth,
minimal residual disease monitoring to deliver development, cognition, and overall health in
risk-adapted therapy to affected children. The these young adult survivors.
trial closed in 2010, (n=556) and significantly
improved OS for all risk categories to 81% Our own studies on childhood cancer
(Yeoh, 2012). survivors (CCS) have revealed similar
concerns. Although predominantly in their
Modern therapies have also elevated survival mid-20s and asymptomatic, we found that our
rates to 75-80% for children with various other Malaysian CCS cohort (n=101) had a cellular

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