ASH 2016: Biomarker May Predict Which Patients Previously Treated for Cancer Will Develop Highly Fatal Form of Leukemia

Key Points

  • Being able to detect therapy-related myeloid neoplasms earlier is crucial, given that the disease usually occurs 3 to 8 years following chemotherapy and/or radiation therapy.
  • Prevalence of preleukemic mutations was significantly higher in patients who developed therapy-related myeloid neoplasms (71%) vs those who did not (26%).
  • Researchers also found genetic mutations that are present in therapy-related myeloid neoplasm leukemia samples could actually be found in blood samples obtained at the time of their original cancer diagnosis.

Patients successfully treated for breast, colon, and other cancers can go on to develop an often-fatal form of leukemia, sometimes years after completion of treatment, due to a genetic mutation leading to secondary malignancies known as therapy-related myeloid neoplasms.

A study conducted by researchers at The University of Texas MD Anderson Cancer Center revealed preleukemic mutations, called clonal hematopoiesis, may predict whether patients develop therapy-related myeloid neoplasms. Clonal hematopoiesis appears to function as a biomarker for patients who develop therapy-related myeloid neoplasms, a leukemia recognized for its extremely poor prognosis. The study findings were published by Takahashi et al in The Lancet Oncology and presented at the 58th Annual Meeting of the American Society of Hematology (ASH) (Abstract 38).

“Therapy-related myeloid neoplasms occur in about 5% of cancer patients who were treated with chemotherapy and/or radiation therapy,” said Andy Futreal, PhD, Chair ad Interim of Genomic Medicine at MD Anderson. “In most cases, it is fatal, and currently there is no way to predict who is at risk or prevent it.”

Being able to detect therapy-related myeloid neoplasms earlier is crucial, given that the disease usually occurs 3 to 8 years following chemotherapy and/or radiation therapy.

“Therapy-related myeloid neoplasms are a problem that needs urgent attention,” said Koichi Takashi, MD, Assistant Professor of Leukemia and Genomic Medicine at MD Anderson. “Since many cancer patients are now living longer, therapy-related myeloid neoplasms are an increasing concern for many cancer survivors.”

Study Findings

Dr. Futreal’s team studied 14 patients with therapy-related myeloid neoplasms and found traces of preleukemic mutations or clonal hematopoiesis in 10. To determine if preleukemic mutations could reliably predict whether the patients would develop leukemia, the researchers compared prevalence of preleukemic mutations in the 14 patients with 54 patients who did not develop therapy-related myeloid neoplasms after therapy.

“We found that prevalence of preleukemic mutations was significantly higher in patients who developed therapy-related myeloid neoplasms (71%) vs those who did not (26%),” said Dr. Futreal. “We also validated these findings in a separate cohort of patients. Based on these findings, we believe preleukemic mutations may function as a new biomarker that would predict therapy-related myeloid neoplasms development.”

In the sample of 14 patients with therapy-related myeloid neoplasms, the team looked at samples of bone marrow at the time of therapy-related myeloid neoplasms development and blood samples obtained at the time of their primary cancer diagnosis.

“We found genetic mutations that are present in therapy-related myeloid neoplasm leukemia samples actually could be found in blood samples obtained at the time of their original cancer diagnosis,” said Dr. Takahashi. “Based on this finding, we believe the data suggest potential approaches of screening for clonal hematopoiesis in cancer patients that may identify patients at risk of developing therapy-related myeloid neoplasms, although further studies are needed.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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