RESEARCH ON LEUKEMIA-CELLS SURPLUS TO DIAGNOSTIC NEEDS IN CHILDREN

The ability to improve diagnosis and refine prognosis in children with acute leukaemia is improving steadily. A growing number of tests can and are being performed on leukaemic cells. These include surface-mark er analysis, DNA content, cytogenetics and studies of gene rearrangeme nts. Increasingly large bone-marrow samples, now usually obtained unde r general anaesthesia, are required to make secure diagnoses. Ethical issues arise from three major areas. 1) Current research on leukaemia cells requested by the Medical Research Council is considered by local research ethics committees, but parents are not regularly given detai led information about or asked specifically to consent to such researc h; 2) substantial quantities of excess cells are stored indefinitely. This archive of stored material is a valuable resource for research bu t there has been little consideration of the ethical issues which aris e from this practice, and 3) there is a potential for pressure to obta in increasingly large samples. 'Creeping growth' in sample size is lik ely to continue unless ethics committees consider future research prop osals in more derail. These issues deserve attention in order that wor thwhile research and its publication are not impeded for want of ethic al consideration. The implications extend beyond the field of childhoo d leukaemia.