Blood cancer treatments have come a long way since the 1950s and scientific advancements continue because of research funded by organizations like the Leukemia & Lymphoma Society of Canada.
From next-generation gene sequencing to the study of biomarkers that affect brain development, innovative research continues to advance the understanding of blood cancers and open the door to novel therapies for these cancers which includes leukemia, lymphoma, myeloma and associated disorders that attack the blood cells, plasma, bone marrow and platelets.
“Treatments for blood cancers are evolving from the whole-blanket approach that’s typical with chemotherapy or radiation, to therapies that are more targeted and specific to each disease,” says Paul O’Connell, manager of medical and scientific engagement at the Leukemia & Lymphoma Society of Canada (LLSC). “Our ultimate goal is to find a cure for the various types of blood cancers, and also to lessen the long-term impact of the diseases and their treatments.”
Treatments have come a long way since the 1950s when the first chemotherapy agents were administered to adults and children with lymphoma and leukemia, and have improved with each passing decade. Today, precise, targeted treatments are possible because of scientific advancements that allow for the study of blood cancers at molecular and cellular levels.
One LLSC-funded study led by Dr. Aly Karsan at the B.C. Cancer Agency in Vancouver is trying to determine whether myelodysplastic syndrome patients who are resistant to a treatment called lenalidomide might benefit from blocking a cell-signalling pathway that plays a critical role in the development and growth of tumours.
“In the last round of LLSC funding, we showed that lenalidomide works by forcing the malignant cells to differentiate into more mature cells, whereupon they die. Mutations in two specific genes will block this differentiation and thus make patients resistant to the drug,” Dr. Karsan says.
“Treatments for blood cancers are evolving from the whole-blanket approach that’s typical with chemotherapy or radiation, to therapies that are more targeted and specific to each disease.” — Paul O’Connell, manager of medical and scientific engagement at the Leukemia & Lymphoma Society of Canada (LLSC).
Overcoming drug resistance in some blood cancer patients is also the focus of another LLSC-funded study, led by Dr. Hong Chang at the University Health Network in Toronto. The doctor’s work aims to overcome drug resistance in patients with multiple myeloma, a bone marrow cancer with survival periods ranging from several months to a few years. Patients with multiple myeloma develop a resistance to treatment after prolonged therapy, rendering the disease incurable.
At the University of Montreal, LLSC-funded work is underway to develop vaccines against acute myeloid leukemia (AML), a cancer of the blood and bone marrow. Researchers are using next-generation genetic sequencing, mass spectrometry and bioinformatics – a field melding biology, statistics and computer science – to discover leukemia antigens that trigger a strong protective immune response and kill leukemia cells. The next step for the doctors is to discover leukemia antigens that can be used as therapeutic vaccines.
Researchers are also using advanced cellular-level science to understand and mitigate the adverse effects of blood cancer treatment. At the Hospital for Sick Children in Toronto, a research team led by geneticist Rosanna Weksberg and hematologist Johann Hitzler is studying how a genetic mechanism plays a role in the brain development of children who have been given chemotherapy for leukemia.
“There are tags on top of our DNA and one tag called DNA methylation tells each cell type which genes to turn on or off to determine whether it will be a brain cell or liver cell, or other types of cells,” Dr. Weksberg says. “DNA methylation is also important in driving normal brain development, so we think what's happening is these tags are being infected by the drug treatment that these children are getting.”
With funding from LLSC, Dr. Weksberg and her team are working to validate preliminary data that show a difference in the DNA methylation tags of children with normal brain function versus those who have experienced brain development problems after chemotherapy.
The goal, she says, is to enable early identification and support of the latter group and to look at treatment that can either prevent these adverse results or work around them.
To date, LLSC has given more than $40-million towards cancer research, through its academic and operating grants, as well as through its New Idea Award competition, which recognize scientists working on potentially transformative cancer research projects. The grants and awards, which are decided by a scientific review panel of leading experts in the field, are funded with donations from individual and corporate donors and sponsors.
Learn more about the 2019 LLSC-funded research projects and how you can donate by visiting llscanada.org/research/research-funding.
As seen in the Globe and Mail on September 16, 2019