Thousands of people learn annually - often after a routine blood test - that they have a precursor condition that may develop into a blood cancer such as leukemia, myelodysplastic syndrome, or multiple myeloma. To identify predictors of cancer progression, Dana-Farber Cancer Institute launched PCROWD, an online crowd-sourcing initiative to collect clinical data from patients diagnosed with these conditions in 2015.
Against the backdrop of PCROWD and much other research by faculty investigators on precursor conditions, Dana-Farber has opened The Center for the Prevention of Progression (CPOP). The first of its kind multi-disciplinary clinic will provide patients with these precursor conditions a roadmap for clinical care and monitoring, while aiding scientists in developing targeted therapies that could halt the progression of precursor conditions before systemic disease or organ damage occurs.
The emphasis will be on early detection of progression from the precursor state to a malignant state, and on research aimed at developing biomarkers to identify patients who are more likely to progress and develop a further malignancy. Researchers will plan clinical trials to evaluate methods of intercepting precursor conditions before they lead to overt cancer or other complications.
Patients will be seen by physicians who specialize in these conditions, and arrange consultation with cardiologists, psychologists, social workers, genetic counselors, and other practitioners to help manage their conditions over time, as needed.
The clinic will also be a resource for healthy individuals who are at high risk as close family members of patients with blood cancers. In addition to those with inherited or germline predispositions, some groups are at particularly high risk: people 70 years and older are at increased risk for CHIP, for example, while MGUS is 3 times more common in African-Americans.
CPOP will provide guidelines for managing the care of patients with precursor conditions, primarily clonal hematopoiesis of indeterminate potential (CHIP); monoclonal gammopathy of undetermined significance (MGUS); lower-risk myelodysplastic syndromes (MDS) and smoldering multiple myeloma (SMM).
"The new clinic is a patient-centered initiative that will harness the breadth and depth of services at Dana-Farber to provide support for individuals with precursor conditions, and to expand treatment options for individuals with these conditions," said Robert Soiffer, MD, chief of the Division of Hematologic Malignancies at Dana-Farber.
Irene Ghobrial, MD, who specializes in research on precursor hematological malignancies specifically MGUS and smoldering myeloma, will serve as the director of the center.
"People with precursor conditions are a population that is growing and will continue to grow as the population ages and as more patients survive therapy for solid tumors. It is clear that CHIP predisposes to cardiovascular death as well as to MDS and leukemia, while MGUS predisposes not only to myeloma but to a variety of renal, dermatological, and immunological conditions," said David Steensma, MD, clinical director of the center. "There are now tools that may prevent complications that deserve testing. We are pleased to provide our colleagues across the Institute and our collaborative sites a place to refer these patients."