Navigation Links
Molecular science could further improve leukemia survival, say St. Jude researchers
Date:3/21/2008

The dramatic increase that has occurred in the cure rate for children with acute lymphoblastic leukemia (ALL) will be difficult to replicate in older patients without considerable additional research, according to an article by St. Jude Childrens Research Hospital authors that appears in the March 22 issue of the Lancet.

In order to raise the survival rate of adolescents and adults with ALL, researchers will need a more thorough understanding of the biology of this form of leukemia, including the role that genes play in therapies, according to Ching-Hon Pui, M.D., chair of the St. Jude Department of Oncology and a leading ALL researcher. Currently, adolescents treated for ALL do not fare as well as children; and among adults with ALL, only 30 to 40 percent are cured.

Cure rates for children with ALLdefined as 10 years of cancer-free survivalwere about 4 percent when St. Jude opened its doors in 1962; but by the end of that decade researchers showed for the first time that treatments using a combination of existing cancer drugs significantly improved ALL survival. Subsequent research at St. Jude contributed in large part to the current high cure rate achieved in children with ALL over the past four decades

ALL is characterized by an abnormal growth of immune-system cells called lymphocytes. About 5,400 new cases will be diagnosed in the United States in 2008, 60 percent of them in children up to age 18. The peak age of diagnosis is 2 to 5 years.

Today, pediatric ALL patients at St. Jude have a cure rate approaching 90 percent, Pui said. We already have 94 percent surviving at 5 years.

In The Lancet article, Pui and his colleagues noted that researchers are investigating two areas of molecular science that hold promise for improving the survival and quality of life of ALL patients, including adolescents and adults.

One is gene-expression profiling, which measures the amount of messenger RNA made by different genes in different cell types; and the other is pharmacogenetics. RNA is the decoded form of genes and is a signal that those genes have been active. Pharmacogenetics is the study of how genes influence a persons responses to drugs.

Although still in the research phase, profiling a cells RNA can identify the major subtypes of ALL and pinpoint genes or chemical signaling pathways that play a role in determining a patients outcome.

Gene expression profiling will help us identify targets for future therapy, Pui said. It is still crude, but in the end, you identify multiple genes for further study. If you find a good target for therapy, the next step is to develop molecular therapeutics for the target.

Even a slight change in a gene may affect the efficacy and toxic side effects of cancer drugs. Originally, researchers focused on the influence of single genes. Now they seek to learn how the combination of gene variations within a cell affects treatment.

Pharmacogenetics is important to finding out a persons response and tolerance for a therapy, Pui said. Certain drugs may be good for 99 percent of patients but bad for 1 percent. We need to find out who those patients are who are at risk so we can spare them from toxicity.

For instance, a genetic alteration affects an enzyme called thiopurine methyltransferase. Children with this alteration cannot metabolize a certain anti-cancer drug, and the active metabolite of the drug can accumulate in the body until it reaches toxic levels. About 10 percent of patients inherit one normal gene and one altered (non-functioning) gene for the enzyme, and one in 300 inherit two non-functioning versions of the gene.

Half of those with the one altered gene and all of those with two altered genes develop low blood cell counts when treated with regular dose of the drug, which can prove fatal in those with two altered genes. Determining the gene status of ALL patients can alert physicians to this risk. The physicians can then lower the treatment dose accordingly.

Some ALL specialists envision a time when oncologists use leukemic cell genetics and host pharmacogenetics to match specific treatments to individual patients.

We need to know the leukemic cell genetics that affect drug sensitivity or resistance and what role pharmacogenetics plays in treatment to improve efficacy and decrease toxicity, Pui said. That way, we dont over treat low-risk patients or under treat high-risk patients.


'/>"/>

Contact: Summer Freeman
summer.freeman@stjude.org
901-435-3061
St. Jude Children's Research Hospital
Source:Eurekalert

Related medicine news :

1. DyCE(TM) (Dynamic Contrast Enhancement) Technology Now Part of CRis Analysis Software Suite for the Popular Maestro(TM) in vivo Molecular Imaging System
2. Molecular biology of sleep apnea could lead to new treatments
3. Allegro Diagnostics Closes $4 Million Round to Develop and Commercialize Lung Cancer Molecular Diagnostics Based on Gene Expression
4. Function of molecular switch pinpointed in severe congenital neutropenia
5. Molecular alliance that sustains embryonic stem cell state
6. Sigma-Aldrich Licenses From NeuroSurvival Technologies a Leading Marker for Molecular Imaging of Apoptosis in Vivo
7. Siemens Receives FDA Approval for the VERSANT 440 Molecular System
8. Molecular glue with new effect
9. Story ideas from Molecular and Cellular Proteomics
10. Findings point to molecular Achilles heel for half of breast cancer tumors
11. The Journal of Biomolecular Screening garners Association TRENDS Bronze Award
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... ... June 24, 2016 , ... People across the U.S. are sharpening their pencils ... an essay contest in which patients and their families pay tribute to a genetic ... 2016 National Society of Genetic Counselors (NSGC) Annual Education Conference (AEC) this September. ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... ... Living, is proud to recognize Dr. Barry M. Weintraub as a prominent plastic ... most beautiful women in the world, and the most handsome men, look naturally ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... actively feeding the Frederick area economy by obtaining investment capital for emerging technology ... past 2½ years that have already resulted in more than a million dollars ...
(Date:6/24/2016)... Washington, D.C. (PRWEB) , ... June 24, 2016 , ... ... Pro-Am Heroes Golf Classic Tournament held on June 20th at the Woodmont Country ... local charity, Luke’s Wings, an organization dedicated to helping service members that have been ...
(Date:6/24/2016)... ... 2016 , ... Advanced Plastic Surgery Institute ( http://www.advancedplasticsurgeryinstitute.com ), ... official Medspa Sponsor. Dr. Josh Olson, a board-certified plastic surgeon, owns the practice, ... says the decision to support the pageant in an official capacity is a ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... SAN CLEMENTE, Calif. , June 24, 2016  American Respiratory ... testing company, is now able to perform sophisticated lung assessments in ... Medical Technologies , Inc. Patients are no longer ... to ndd,s EasyOne PRO ® , ARL patients like Jeanne R. ... testing done in the comfort of her own home. ...
(Date:6/24/2016)... , June 24, 2016 ... appointment of Dr. Edward Futcher to ... Director, effective June 23, 2016.Dr. Futcher was also ... and Governance Committees.  As a non-executive member of ... expertise and strategic counsel to VolitionRx in connection ...
(Date:6/23/2016)... BEVERLY HILLS, Calif. , June 23, 2016 ... faced the many challenges of the current process. Many of ... option because of the technical difficulties and high laboratory costs ... would have to offer it at such a high cost ... to afford it. Dr. Parsa Zadeh , ...
Breaking Medicine Technology: