Sometimes lymphoma treatment has an unexpected and tragic side effect: Patients can later develop an aggressive form of leukemia or a related blood disease. But City of Hope scientists recently pinpointed a few genetic changes that seem to identify the patients most at risk.
For some patients, treatment of lymphoma, left, can lead to leukemia, right. (Courtesy of National Cancer Institute/Dr. Lance Liotta Laboratory)
Tracking down these genetic changes will teach scientists important facts about how acute myeloid leukemia (AML) and therapy-related myelodysplasia (t-MDS) develop. It could lead to new ways to prevent the diseases or treat them more effectively.
It’s just one of the pieces of research supported through the Tim Nesvig Lymphoma Fellowship and Research Fund, but it symbolizes the wide impact of studies funded through the effort. The fund backs studies into advanced strategies, like engineering T cells to attack lymphoma and testing new drugs to fight recurrent lymphoma, as well as ways to improve stem cell transplantation and other projects.
Now, by illuminating how t-MDS and AML develop, the funded scientists have uncovered some surprising information about the diseases’ early stages.
They found that even before patients in their study were treated for lymphoma, there was already evidence of leukemia deep inside the patients. Specifically, stem cells in their blood already had some genetic twists that put them on the road toward developing leukemia, according to Ravi Bhatia, M.D., director of the Division of Hematopoietic Stem Cell and Leukemia Research and co-principal investigator on the study. These changes might have made the cells particularly susceptible to damage during lymphoma treatment, but some of these patients might have developed leukemia even without cancer treatment, he said.
If scientists learn more about how these genetic changes make patients susceptible to leukemia, they may be able to detect the changes in advance — and design ways to prevent leukemia from developing.