Cancers of the lymphatic system: clinical and translational research
Non-Hodgkin's lymphoma (NHL) is the fourth most common cancer in children and adolescents. It is a group of malignant diseases of the lymphatic system that can affect all organs, including lymph nodes, bone marrow, lymphatic tissues of the tonsils, spleen, and intestines. Prof Wilhelm Wößmann has researched this cancer at various levels with his "Non-Hodgkin's lymphoma" working group, based at the Research Institute Children's Cancer Centre Hamburg since January 2025.
Prof. Wößmann has been Deputy Director of the Department of Haematology and Oncology at the University Medical Center Hamburg-Eppendorf since 2018 and has researched Non-Hodgkin's lymphomas for over 20 years. He runs the NHL registry together with Prof Dr Dr Birgit Burkhardt from Münster University Hospital. A structured database collects, documents, and analyses information on the diagnosis, treatment, and progression of NHL in children and adolescents. The aim is to improve patient care through clinical and laboratory research, also on residual material. Wößmann is also conducting a Europe-wide study on anaplastic large cell lymphoma (ALCL), the third most common form of NHL in this age group. The study is the first to test mild outpatient chemotherapy. He is planning further clinical trials with new targeted drugs.
Together with the NHL-group at the department of pediatric hematology and oncology at Münster University Hospital, the NHL-team in Hamburg offers quality control of diagnosis and staging for all pediatric NHL-patients, and provides counseling for other pediatric oncologists. The Hamburg NHL laboratory is a reference laboratory for NHL in children and adolescents. It performs reference cytology pleural effusions and ascites, cerebrospinal fluid and bone marrow. It determines the minimal residual disease (MRD), which guides therapy in some subgroups and relapses.
Developing methods for diagnostics
A few years ago, the pediatric oncologist and his team established a reliable method for detecting minimal residual disease in ALCL. Specific gene transcripts are detected using the polymerase chain reaction (PCR). The transcripts consist of RNA, which is less stable in the laboratory than DNA. Scientists are, therefore, currently investigating whether the minimal residual disease can also be determined at the DNA level, for example, by analyzing cell-free DNA.
Decoding resistance mechanisms of lymphomas
Together with researchers from Kiel and Essen, the working group is investigating resistance mechanisms of ALCL, i.e., why chemotherapy works in some children with ALCL but not others. Initial results indicate that that differences in sensitivity to therapy exist from the outset. "We don't yet understand these differences," says Wößmann. "The tumor cells look the same and show the same main chromosomal changes. We are currently investigating whether the children have differently strong immune systems against ALCL or whether the properties of the tumor cells are different." The researchers in Hamburg systematically determine antibodies in the blood of patients, search for cellular immune responses, and compare genetic differences between patients that may weaken the defense system. At the same time, these investigations create the basis for developing an immunotherapy to reduce the risk of relapse.
Cooperation and exchange
By joining the research institute, Wößmann looks forward to intensifying dialogue with the other working groups, such as those researching antibody detection methods or cell-free DNA research. One particularly exciting question, for example, is whether tumor heterogeneity can be better detected by cell-free DNA than tumor tissue samples.
