App that helps fight with children’s leukemia

In 2018, an application created by a group of Silesian IT specialists, programmers and analysts reached Polish hospitals treating children with leukemia. The project participants included specialists from 3Soft. They designed special software in cooperation with doctors. The application enables data systematization and faster data analysis. Since its debut, the system has supported the treatment of nearly 1,000 children and has significantly reduced the time needed to transfer information between medical facilities.

Until a few years ago, when leukemia was diagnosed in a child, the exchange of information between medical facilities took up to several days. Test results were sent from specialized testing centers, e.g. in Bydgoszcz, to individual hospitals, e.g. in Zabrze. This was usually done via a courier. Only after receiving the results did doctors analyze them and made decisions regarding further therapy. Meanwhile, the protocols developed by a team of international specialists show how much time matters. Certain steps related to treatment should be taken within no more than a few days of various stages of disease progression. Therefore, a decision was made to develop an information system to streamline the entire process.

Cooperation with doctors

Developers and analysts faced two major challenges. The first one was related to creating the system from the programming side. The second one – with adapting it to the factual content of the protocols developed by the experts. Among other things, the application developers had to take into account what parameters doctors would be allowed to enter, how the contingency reporting system would work, and how the patient’s “path” would be shown at each stage of the protocol.

In 2017, there appeared a need for creating an online application to document the course of treatment and its possible complications in real time. This allows a real assessment of the results of the treatment protocol. First, a system was created to document the set of necessary diagnostic tests required to assign patients to specific risk groups. Then, various phases of treatment were implemented. This required very close cooperation between programmers and clinicians,

says Professor Tomasz Szczepanski, MD, PhD, Head of the Silesian Medical University in Katowice.

When we took on the task of developing such an application, it was crucial for us to deliver one that would meet the expectations of doctors. We had the opportunity to see an Excel-based system that had been in operation abroad for a long time. It was given as an analogy for what we were about to create. We noticed how many years had passed since the debut of that version. We saw how much could be done better,

explains Michal Krzesiak of 3Soft, who took part in the development of the Polish application.

We listened to the voices of Polish oncologists and experts. They were the ones who knew best what worked well in the system of treatment of children with leukemia, what posed the biggest problems, and what features in the application would be the most needed,

adds Michal Krzesiak.

All information in one place

The key thing about the app is that it facilitates access to information on treatment history. It shows in a clear way what steps in the protocol have already been taken and what stage of treatment the patient is currently at. It can be likened to a virtual, interactive, detailed and continuously updated information database. It takes merely seconds for test results entered in one of the test centers to be available to the attending physician. Requests for resampling or providing additional test material are made faster. Automated data analysis allows for far more efficient and faster decision-making within the adopted treatment path.

The development of the system has enabled multicenter clinical trials to be conducted in childhood acute lymphoblastic leukemia as part of the cALL-POL project. The system made it possible to monitor the course of treatment in accordance with international standards,

says Professor Tomasz Szczepanski, MD, PhD, Head of the Silesian Medical University in Katowice.

What is more, the application can be accessed by doctors from any location, and the data entered is systematized accordingly.

Division into modules and ongoing support

To streamline operations, the application is divided into 7 modules, including Patients Zone, Biobank Zone, and Pharmacovigilance, where adverse events can be observed. The modules are interconnected and provide one another with information, depending on the needs and adopted schemes.

Division of the application into modules allows controlling access. Experts who deal with the analysis of adverse effects do not have to search for them in individual patients’ charts. All information is available in one place prepared for them. This prevents accidental deletion of data. On top of that, the application ensures patient anonymity with each patient given an individual identifier under which they appear in the system. The ID is known only to the attending physician and other authorized persons. This makes it possible to use the database stored in the application not only to treat patients, but also to conduct research on the data available there. All this to further improve the treatment of children with leukemia,

explains Michal Krzesiak.

It should be emphasized that we are talking about experimental treatment pathways that require continuous monitoring of a number of factors and parameters before planning further steps of therapy. This results in new needs that arise on the doctors’ side. Therefore, the application is being updated with more solutions. Recently, for example, it was the ability to divert a patient to another treatment path without losing historical data. Another added feature is information about patient’s relocation to another facility.

Leukemia is the most common cancer in children

Every year in Europe, 35,000 children are diagnosed with cancer. Leukemia is the most common childhood cancer and accounts for as much as 25% of all cases. In Poland, about 300 cases are diagnosed each year.

Leukemia is cancer of the blood and bone marrow that, due to the formation of large numbers of immature, defective blood cells, prevents the blood cells from functioning properly. Types of leukemia vary, but the type most common in children is acute lymphoblastic leukemia, abbreviated ALL. Fortunately, thanks to increasingly better treatment techniques and improved procedures, even with B-type acute lymphoblastic leukemia the chances of survival are over 90%. The role of such systems as the application operating in Poland is not without significance here,

says Ewa Majewska, editor-in-chief of the onkorodzice.pl portal.

It is important to keep the application running and provide the necessary technical support. We should add that the system was developed under the Strategmed program of Poland’s National Center for Research and Development, and is currently being financed by the cALL-POL program.

It is also worth mentioning that the onkorodzice.pl portal has been in operation in Poland since February 2021.

The portal is a base of knowledge on childhood cancers, created by patients’ parents, together with doctors and specialists. There you can find a range of important, organized and verified information, from the description of types of cancer, diagnosis, symptoms, treatment, through various forms of support – both for the sick child and his or her caregivers. The portal was created and is still being developed in cooperation between the Iskierka Foundation and its partners. In terms of technology, the support is provided by 3Soft,

explains Ewa Majewska.