Elijah Amoah. Photo / Mark Mitchell
Dr Andrew Wood has won many battles in his war against child cancer, but says it's those he has lost now driving him towards new treatments in a cutting-edge research programme.
The paediatric haematologist-oncologist has returned home from the United States' top-ranked children's hospital to lead a major effort targeting a type of cancer where only 60 per cent of children diagnosed with it are cured.
Those who do survive acute myeloid leukaemia, or AML - a cancer typified by an increased number of abnormal white blood cells, called myeloid cells - have to endure intensive chemotherapy and sometimes stem cell transplants.
Speaking to the
Herald
ahead of the Red Nose Day appeal on Friday, the former Fulbright scholar said his mission was to not only find potential cures for the disease, but also therapies that are more gentle.
Taking what he's learned from seven years at the renowned Children's Hospital of Philadelphia, his small team at the University of Auckland are now putting together genetic models of AML they hope could ultimately yield the disease's Achilles heel.
"There has been an explosion of knowledge cataloguing all of the different types of mutations in cancer, but our understanding of how those different mutations work and how they co-operate - that's what we are only just beginning to catch up on."
His team are taking cancer cells from patients and genetically modifying them to help understand how these mutations work together to cause disease and resist current treatments.
They are also introducing them into tropical zebra fish, which have proven valuable to scientists because they develop blood in a similar way to humans.
"If you study things just in a petrie dish, it's often got no chance of working in something as complex as a human being - yet this approach offers us a way to make genetic alterations and examine the mutations' consequences in real life."
Dr Wood expected the first models would be ready for testing within a year, but added there was no timeframe on the programme itself.
"There are so many different sub-types of cancer we need to model that there is going to be a continual flow of building models and testing them."
Within a decade, he hopes patients will be treated with a broader range of options instead of relying largely on chemotherapy.
"I think things are particularly going to expand in the classes of small molecules that we use to inhibit biological circuits, and we are going to see big expansions in therapies that harness the immune system.
"All of that is going to be coupled with a much deeper understanding of the genetic complexity of each person, and the ultimate ideal is we will be able to better individualise different aspects of therapy."
Today, leaps in basic science knowledge were being made faster than they could be applied, and Dr Wood hoped what his team discovered could help translate these medical discoveries into better treatments.
Dr Wood is also a clinician at Starship Children's Hospital.
"It's extraordinarily gratifying to be part of a team that can look after and more often than not cure children, but there are also many times where we can't, and that's an incredibly brutal experience for the child, the family and the team," he said.
"For me, it was the frustration of that experience that really drove me into research - having seen that happen enough times, I wanted to have more cures and less failures."
While he admitted New Zealand was a much smaller environment than his previous posting, Dr Wood said our country punched well above its weight when it came to cancer research.
"People have done research from New Zealand that has been so meaningful it's had an impact on patients all around the world."
Dr Wood's work is being supported by Cure Kids, the Auckland Medical Research Foundation Goodfellow Repatriation Award and the Child Cancer Foundation.
Before Elijah Amoah was diagnosed with cancer in 2007 at the age of 3, there was little to tell his mother and father just how sick he was.
When the Wellington boy grew clingy and began falling asleep on the couch in afternoons, his parents put it down to starting at kindergarten.
It was only after he fell over in a playground that they noticed swelling in Elijah's jaw and took him to see the doctor. Even then, it was assumed the boy had a case of glandular fever - leukaemia was suggested, but only as a slim possibility that would be tested for.
"It was just horrendous, it was awful," his mum Olivia Amoah said of later being told her son had acute lymphoblastic leukemia.
What began with immediate treatment in Christchurch rolled into years of hospital stays and heart-wrenching ups and downs.
The family was heartened when a bone marrow transplant was able to be taken from his younger brother Taziyah - something so unlikely Mrs Amoah compared it to winning the lottery. But the family was knocked again when Elijah relapsed a second time.
Somehow, chirpy Elijah has managed to battle back and much to his parents' amazement and joy, the 11-year-old is now in remission and catching up on three years of missed school.
"Most kids who relapse twice don't actually end up surviving, so he's pretty much a miracle," Mrs Amoah said. "Leukaemia is so common but it's really scary - and when people say 'oh you're lucky because that's the one with the highest cure rate', it makes me so angry as it's also the cancer with the longest treatment, the harshest treatment, and it's a huge ordeal for any family to go through."
News that a fresh research effort would look at ways to ease the plight of young leukemia sufferers like Elijah was exciting, she said.
"Anything that can improve things at the moment and make it easier on these kids is so crucial."
• Leukaemia is cancer of the white blood cells. The bone marrow and other blood forming organs produce increased numbers of abnormal white blood cells, and the rapid growth of these suppresses the production of normal blood cells.
• Leukaemia is the most common childhood cancer, but about 90 per cent of all leukaemias are diagnosed in adults.
• The most common form, acute lymphoblastic leukaemia, or ALL, increases the number of white blood cells called lymphocytes and accounts for 30 per cent of childhood cancers. On average, between 75 and 80 per cent of children with ALL survive, however survival rates are poorer for adolescents and young adults, at 51 per cent.
• The form being targeted by Dr Andrew Wood and his Auckland University research team, acute myeloid leukaemia, or AML, involves an increased number of abnormal white blood cells, called myeloid cells. Because AML is harder to treat than ALL, survival rates are even lower. Fifty per cent of childhood AML patients and 42 per cent of adolescent AML patients survive.
• Cure Kids, the charity behind the annual Red Nose Day appeal happening this Friday, hopes to raise more than $1 million to save, improve and extend the lives of thousands of kids.
• Donations can be made online through the Red Nose Day website, by texting NOSE to 933, or at participating retailers around New Zealand.
• You can also show your support by posting red-nosed photos on social media using the #REDicuous and #RedNoseDayNZ hashtags.
• For Red Nose Day updates, follow Cure Kids on Facebook, Twitter, or YouTube.
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