At the Hematology Research Seminar Friday, August 3, Nina Kadan-Lottick, MD, associate professor of pediatrics (hematology/oncology), presented research on a rare form of leukemia to scientists and adult oncologists, an audience of potential collaborators.
“A few years ago,” she says, “we learned about this entity that really transformed the way we stratify leukemia.” That entity was Philadelphia chromosome-like Acute Lymphoblastic Leukemia (Ph-like ALL), a rare cancer that confers lower odds of survival and appears in approximately 5,000 adults and children in the United States each year. Scientists named Ph-like ALL for its clinical resemblance to another form of leukemia called Ph-positive ALL that results from bone marrow cells or leukocytes containing an abnormality of chromosome 22.
In 2009, two groups of researchers, one from the Netherlands and one from St. Jude Children’s Research Hospital in Tennessee, compared genetic profiles of 107 pediatric ALL patients and discovered this subtype of leukemia.
Ph-like ALL is caused by genetic changes to a molecular signaling pathway that regulates cell division and programmed cell death in leukocytes. In some patients, alterations in one such pathway, the JAK/STAT pathway, lead to cancer development while in others, changes in the ABL pathway are the culprit. In a few outlying cases, the genetic alterations affect other signaling pathways in leukocytes, instead. Alterations in any of these pathways cause the same cancerous effects. To appropriately treat the cancer in each individual, oncologists need to identify which pathway is causing the disease.
Identifying the pathway in each patient to target for treatment is the current challenge for the field. This challenge, Kadan-Lottick says, “I believe is a unique opportunity to increase cure rates because we can target what specifically goes wrong in the development of certain subtypes of Leukemia.”
Because Ph-like ALL is so rare, adult and pediatric oncologists need to pool their resources and collaborate to develop treatments for this cancer and find a cure, says Kadan-Lottick.