The Leukemia & Lymphoma Society: Putting Prevention In The Spotlight

Issue 24, Winter/Spring 2015

The Leukemia & Lymphoma Society (LLS) exists to find cures and ensure access to treatments for blood cancer patients. We continue to operate by the same guiding principles set forth by the couple that founded our organization 65 years ago: to cure blood cancers and improve the quality of life for patients and their families.

LLS Light the Night Walk

LLS was born in 1949 out of a family's grief following the death of their teenage son from leukemia. Now, 65 years later, we have seen enormous progress, with five-year survival rates for many patients having doubled or tripled, and in some cases quadrupled. Survival rates for children with acute lymphoblastic leukemia, the most common childhood cancer, have risen over the past 40 years from 3 percent to nearly 90 percent today; Hodgkin lymphoma patient survival rates have doubled to 88 percent since the 1960s, and survival rates for myeloma patients have tripled in the past decade. Yet, more than 1 million North Americans are fighting blood cancers and despite progress, more than a third of blood cancer patients still do not survive five years after their diagnosis. So more funding is needed to advance research and help save more lives.

As there are few means of preventing or early detection for blood cancers, LLS is focused on finding cures. To date we have invested more than $1 billion in blood cancer research to advance therapies. However, to achieve a world without blood cancers, prevention is our ultimate goal. There are several types of blood cancers that can evolve from a less severe case into a more lethal type. We view these diseases as an opportunity to test approaches to prevention and LLS is investing in multiple projects aimed at preventing progression.

All of us at LLS were moved when we learned of the death of the supremely talented author and filmmaker, Nora Ephron, who died from acute myeloid leukemia (AML) in 2012. Ephron had been diagnosed with myelodysplastic syndrome (MDS), which she lived with for several years but which then progressed to the more deadly AML. MDS is a group of diseases of the blood and bone marrow, with varying degrees of severity. Sometimes MDS can develop as a result of treatment for a different cancer years earlier. Approximately 1/3 of MDS cases progress to AML, a deadly disease with poor treatment options.

One of LLS's more ambitious and innovative grants programs – the prestigious Marshall A. Lichtman Specialized Center of Research (SCOR) research initiative – funds teams of researchers representing different disciplines and engaged in collaborative efforts to discover new approaches to treat patients with blood cancers. One of these teams, led by Irene Ghobrial, MD, associate professor of medicine at Harvard Medical School and director, Michele & Stephen Kirsch Laboratory at Dana-Farber Cancer Institute in Boston, is collaborating with an esteemed group of co-investigators at Harvard School of Public Health, Brigham and Women's Hospital in Boston, Memorial Sloan Kettering Cancer Center, University of Texas MD Anderson Cancer Center and Massachusetts General Hospital to understand the molecular basis of the progression from less to more severe blood cancers. In particular, they are seeking to identify the genetic drivers that cause the progression of MDS and myeloproliferative neoplasms (MPN) to AML.

In addition, the team is studying the genetic drivers that cause monoclonal gammopathy of undetermined significance (MGUS), a disease known to progress to another form of blood cancer, multiple myeloma (MM). Finally, they are attempting to determine whether there are other such early disease states that can be identified genetically. By understanding the progression of these diseases, it may be possible to identify therapies targeted to the pre-AML and pre-MM states.

Although many patients are diagnosed with these precursor diseases, they do not receive treatment until their disease progresses, at which time they have overt symptomatic disease with damage to many of their organs. It is therefore not surprising that even with the best combinations of therapies currently available, most patients with MM or AML are not cured. By using genomics and other research strategies we anticipate that Dr. Ghobrial's team will gain a better understanding of the progression and evolution of genetic changes in blood cancers and develop targeted therapies that can treat these cancers at an earlier stage, eliminating progression to more deadly blood cancers.

LLS has committed $6.25 million to the team from 2013 through 2018.

The Ghobrial team is just one example of many projects that LLS is funding to prevent progression of disease from one state to another. LLS also funds research focused on preventing relapse of blood cancers. And at LLS we are also setting our sights on prevention before any cancer occurs, with plans to fund research studying the root causes of the specific blood cancers, identification of pre-malignant disease markers in the blood or tissue and ultimately new drug targets that can be used safely to prevent or slow the development of new blood cancers.

Louis J. DeGennaro, PhD

Louis J. DeGennaro, PhD
Interim Chief Executive Officer and Chief Mission Officer
The Leukemia & Lymphoma Society
White Plains, NY