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New Bloodwise research published

The Bloodwise logo. Bloodwise appears in black text against a white background
Posted by
06 Sep 2016

Throughout the year, Bloodwise researchers publish findings from the research they've been working on, thanks to the funding we've been able to give them as a result of your support. Here's an overview of some of the very latest Bloodwise research news.

Is the number of patients living with blood cancer underestimated?

The Haematological Malignancy Research Network (HMRN) is a major Bloodwise-funded initiative based at the University of York that records detailed clinical information of all blood cancer patients registered in the Yorkshire and Humberside region. Using this comprehensive database, HMRN researchers attempted to refine estimations of the total number of people living with blood cancer across the UK. This kind of information is hugely important if we're to raise awareness of the importance of blood cancer as an issue.

The results, published in the journal Cancer Causes Controlsuggested that current methods used to record cancer diagnoses could underestimate the total prevalence of blood cancers. At present, statisticians estimate the number of people living with haematological disorders by simply recording all people diagnosed by the NHS during a given time period. The new study indicated however, that patients with illnesses that do not require regular treatment, or who were previously 'cured', can be overlooked by cancer registries. This means there may be more patients living with or surviving certain types of blood cancer than are currently recognised. The new analysis estimates that total number of people living with or beyond blood cancer could reach 328,000, which is up on previous estimates at 230,000. 

It's important to note that this finding was an estimate made using modelling techniques and isn't a definitive figure. Long-term measurements using standardised approaches (such as 20-year prevalence) remain the preferred approach, but this study poses interesting questions on how we estimate the number of blood cancer patients in the UK.

Infant leukaemia: the cell of origin?

Although most children diagnosed with leukaemia have witnessed consistent improvements in their survival prospects since the 1960s, there remain some who still receive a poor prognosis. One such condition is infant B-cell acute lymphoblastic leukaemia (iALL), a type of childhood leukaemia that arises within a year of birth and is particularly aggressive and hard to treat.

An early-career scientist Dr Katrin Ottersbach, supported by a Bloodwise Bennett Fellowship, has overcome some major obstacles in the study of iALL to identify the cells and the critical time window in which the disease may first emerge in the developing embryo.

iALL is known to be caused by big chunks of DNA swapping places inside blood cells, although when and where this happens in the womb is unclear. Dr Ottersbach isolated these unusual chunks of DNA and, at different stages of embryonic development in mice, inserted them into the first blood cells that emerge. This clever strategy revealed that a crucial window exists, 12 or 14 days after fertilisation, where the dysfunctional DNA caused unusual growth of early-stage blood cells. This precisely timed genetic alteration may be the initiating event of iALL, although further changes appear necessary for full blown iALL to develop.

Dr Ottersbach's findings can now be used as a platform for researchers to characterise the next events in the natural sequence of iALL development. With improved understanding of this process, new more taregeted treatment strategies can be developed towards improving outcomes for children with this complex condition. To read the full paper see here

A role for bone marrow support cells in MGUS and myeloma

A group of Bloodwise-funded researchers published a new study in the internationally renowned journal Leukemia, identifying a potentially important genetic change that's shared between myeloma and its precursor condition monoclonal gammopathy of undetermined significance (MGUS).

Working out what causes the switch between MGUS and myeloma remains an unsolved problem, particularly as both conditions have until now appeared very similar at the genetic level. By turning to changes in cells that affect how active the genes are, the researchers revealed that an important protein signal, called PADI2, is more abundant in bone marrow samples taken from both MGUS and myeloma patients compared to healthy controls.

This field of genetics, known as 'epigenetics', focuses on reversible chemical flags that stuck on to the DNA double helix by carefully controlled cellular signals. These changes can directly alter the activity of the genes in a cell-specific manner, meaning individual cells can express the DNA code differently and become all the different types of cells in our bodies. Abnormal function of the epigenetic process is now becoming more well known in cancer, including blood cancers. 

This finding was particularly unusual because the key epigenetic change was found not in cancerous blood cells but within support cells of the bone marrow. Excessive amounts of this protein caused changes to the immune chemicals secreted by the support cells, which created a protective environment for the cancer to develop unchallenged by immune 'police' cells.

This research emphasises the importance of looking for epigenetic changes when studying blood cancers and also defines a role for support cells as triggers for the development of MGUS and myeloma. Pinpointing the critical steps that drive myeloma's emergence from MGUS remains an essential part of research efforts aiming to prevent this switch from happening.

One-stop shop method for blood cancer diagnosis

The final snippet of Bloodwise-funded research we wanted to tell you about is a technical breakthrough that possesses enormous potential for doctors’ ability to accurately diagnose blood cancers. An international team of researchers, led by Dr George Vassiliou at the Wellcome Trust Sanger Institute, Cambridge, has developed a fast and streamlined new method for diagnosing the different types of acute myeloid leukaemia (AML) and myelodysplastic syndromes (MDS).

We talked about this research in a short blog already, which covers the study in more detail, but due to the potential implications of this work, we felt it was worth flagging again.

The researchers developed a tool that could replace the numerous complex and laborious genetic experiments currently required for a precise AML or MDS diagnosis. Their new technique requires just a single DNA sample before spinning out an accurate genetic breakdown with greater speed and detail than is currently possible in routine diagnostics. This would help doctors to better tailor the treatment approach for individual patients, whether it's certain targeted drugs or more intense chemotherapy. This approach could potentially be modified for any type of blood cancer and provides an encouraging snapshot of how personalised diagnoses of blood cancers may be performed in future.

We hope you've enjoyed reading about this most recent research that your support has funded.

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