DNA Analysis Predicts Blood Cancer Progression Ahead of Traditional Tests
New research indicates that DNA patterns might identify the progression of certain blood cancers years before traditional tests. This study, published in the journal Cancer Discovery by the American Association for Cancer Research, tracked 30 individuals with myeloproliferative neoplasms (MPNs), a cluster of blood cancers where the marrow generates excess blood cells.
Researchers observed DNA in the blood and bone marrow of patients to spot genetic variations. They assessed whether these variations corresponded with blood counts, disease stability, or progression to myelofibrosis or acute leukemia.
Stable patients frequently exhibited stable DNA, lacking cancer-related genetic changes, suggesting they are more likely to maintain stability. Patients with stable diseases showed little genetic evolution.
Conversely, those with worsening conditions showed DNA changes well before routine tests detected it. These changes involved new groups of abnormal cells forming and expanding.
Nine participants developed acute myeloid leukemia (AML), albeit with different progression patterns. Some had MPN cells acquiring detrimental mutations, while others faced leukemia originating from distinct abnormal blood cell groups. Similar disparities appeared in those who developed myelofibrosis.
The study also discovered that hydroxyurea, a drug used to manage blood counts in MPN patients, leaves a distinct pattern of minor DNA changes. However, there’s no evidence linking the drug to leukemia. Azacitidine, another drug treating blood cancers, showed a similar DNA alteration pattern. Genetic changes appeared years before traditional tests noted disease progression.
Three individuals with ‘triple-negative’ essential thrombocythemia did not display genetic cancer indicators, suggesting some diagnoses may not require long-term treatment.
Despite its small sample size, the study highlights associations without establishing causality.
Dr. Abhishek Chilkulwar, an oncologist, remarked that those with MPNs can often live long lives. He emphasized that blood cancers might unveil their trajectory in DNA long before symptoms arise, marking a step toward precision medicine.
He described the findings as indicative of emerging precision medicine for preventing blood cancers, using genetic data to forecast risks and potentially intervening early.
Re-testing a patient’s DNA periodically might alert doctors to potential dangerous progression before it appears in routine tests.
In the future, combining early genetic detection with medications acting on specific mutations might prevent or delay disease advancement.
Currently, practical uses might involve closer monitoring instead of new treatments. Discovering a high-risk mutation could lead to more frequent blood and bone marrow checks to catch progression early. However, it wouldn’t justify transplant evaluations, which remain for progressed patients.
The next step involves aligning early detection with mutation-targeting drugs to potentially avert or slow disease development.