The Myeloma Institute is the only facility in the world that routinely offers gene array analysis for newly referred patients and utilizes this information for patient management and planning of therapy. Researchers at the Myeloma Institute use state-of-the-art gene array analysis to characterize molecular features of myeloma. They can apply this knowledge to more accurately predict which patients will benefit the most from specific therapies.
The Myeloma Institute performs multiple gene arrays on every patient enrolled on a clinical protocol. Based on a study of more than 500 newly diagnosed patients treated at the Myeloma Institute for multiple myeloma, our researchers found that the expression of just 17 genes (out of the 25,000 genes in the human body) revealed which form of myeloma a patient had. The expression level of those 17 genes serves as a powerful predictor of response to therapy. This enables doctors to more accurately predict which patients will not respond to standard therapy and thereby spare patients from undergoing treatments that will not be effective. The discovery is also important to the development of new treatments that specifically target the 17 genes.
The newest GEP project led by Christoph Hueck, MD, involves the analysis of prospectively collected clinical data as well as tissue specimens from the approximately 10,000 patients treated at the Myeloma Institute since 1989. While GEP has been applied to a portion of specimens using modern high-throughput techniques, numerous samples collected prior to the introduction of GEP technology have not been processed. The project involves processing the untouched bone marrow aspirate and biopsy samples using GEP. Analysis of clinical data and tissue specimens will yield a more in-depth understanding of the biology of myeloma cells and their microenvironment.
The GEP data is being biostatistically integrated with clinical data in order to gain insight about factors that predict response to treatment as well as treatment targets based on pathogenesis.
The goal of this MRD project, led by Sarah Johnson, PhD, is to detect and enumerate by multiparameter flow cytometry residual tumor cells in patients with myeloma following high dose therapy, and to characterize these cells using highly sensitive molecular techniques. Hypothesizing that these cells are resistant to therapy and represent the cells responsible for eventual relapses, we expect that characterization of these cells will allow us to detect potential relapses much earlier than traditional methods and to incorporate therapeutic interventions designed specifically to target these cells.
Myelodysplastic syndrome is a disease in which the bone marrow does not make enough healthy blood cells. In a healthy person, the bone marrow makes blood stem cells that become mature blood cells over time. A blood stem cell may become a myeloid stem cell or a lymphoid stem cell. Lymphoid stem cells become a white blood cell and myeloid stem cells become either red blood cells, platelets or white blood cells.
In a patient with a myelodysplastic syndrome, the blood stem cells do not become healthy red blood cells, white blood cells, or platelets. The immature blood cells (blasts) do not work the way they should and either die in the bone marrow or soon after they go into the blood, leaving less room for healthy white blood cells and greater risk of infection, anemia, or easy bleeding. Age and past treatment with chemotherapy or radiation therapy affect the risk of a myelodysplastic syndrome. For this research, Joshua Epstein, PhD is focused on developing a predictive model for patients at risk of developing MDS as a result of extensive myeloma therapy.
Ricky Edmondson, PhD, Associate Professor of Medicine; Funded by the Multiple Myeloma Research Foundation
Funded by the Nancy and Stephen Grand Philanthropic Foundation
Ya-wei Qiang, MD, PhD; Funded by the Multiple Myeloma Research Foundation
Funded by the Multiple Myeloma Research Foundation
Frits van Rhee, MD, PhD
Frits van Rhee, MD, PhD
Shmuel Yaccoby, PhD; Funded by BioInvent International AB