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Chromosomal Rearrangement Is the Key to Progress Against Aggressive Infant Leukemia

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Newswise (MEMPHIS, Tenn. March 6, 2015) The St. Jude Childrens Research HospitalWashington University Pediatric Cancer Genome Project reports that a highly aggressive form of leukemia in infants has surprisingly few mutations beyond the chromosomal rearrangement that affects the MLL gene. The findings suggest that targeting the alteration is likely the key to improved survival. The research appeared online ahead of print this week in the scientific journal Nature Genetics.

The study is the most comprehensive analysis yet of this rare but aggressive subtype of pediatric acute lymphoblastic leukemia (ALL) that occurs during the first year of life and is sometimes diagnosed at birth. The leukemia cells of up to 80 percent of infants with ALL have a chromosomal rearrangement that fuses the MLL gene to a gene on a different chromosome. The resulting MLL fusion gene encodes an abnormal protein. The fusion protein plays a key role in transforming normal blood cells into leukemia cells.

Researchers used whole genome sequencing and other techniques to identify the genetic alterations in 65 infants with ALL, including 47 with the MLL rearrangement. Scientists were surprised to find that despite being an aggressive leukemia, the MLL rearranged subtype had among the lowest mutation rates reported for any cancer.

These results show that to improve survival for patients with this aggressive leukemia we need to develop drugs that target the abnormal proteins produced by the MLL fusion gene or that interact with the abnormal MLL fusion protein to shut down the cellular machinery that drives their tumors, said senior and co-corresponding author James R. Downing, M.D., St. Jude president and chief executive officer. That will not be easy, but this study found no obvious cooperating mutations to target.

St. Jude researchers are working to identify compounds and develop combination therapies to improve cure rates for infants with the MLL rearrangement. Nationally, 85 percent of pediatric ALL patients now enjoy long-term, cancer free survival compared to 28 to 36 percent of infants with the high-risk subtype.

We frequently associate a cancers aggressiveness with its mutation rate, but this work indicates that the two dont always go hand-in-hand, said co-author Richard K. Wilson, Ph.D., director of The Genome Institute at Washington University School of Medicine in St. Louis. Still, our findings provide a new direction for developing more effective treatments for these very young patients.

The other corresponding authors are Tanja Gruber, M.D., Ph.D., assistant member in the St. Jude Department of Oncology, and Anna Andersson, Ph.D., formerly of St. Jude and now of Lund University, Sweden. Andersson and Jing Ma, Ph.D., of the St. Jude Department of Pathology, are co-first authors.

Almost half of infants with MLL rearranged ALL had activating mutations in a biochemical pathway called the tyrosine kinase-phosphoinositide-3-kinase (PI3K)-RAS pathway. Surprisingly, the mutations were often present in only some of the leukemic cells. Researchers analyzed leukemia cells in infants whose cancer returned after treatment and found that at the time of relapse the cells lacked the pathway mutations. The fact that the mutations were often lost at relapse suggests that patients are unlikely to benefit from therapeutically targeting these mutations at diagnosis, Downing said.

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Chromosomal Rearrangement Is the Key to Progress Against Aggressive Infant Leukemia

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Be Wary of Websites Selling Genetic Cancer Tests: Study

THURSDAY, March 5, 2015 (HealthDay News) -- Websites that offer personalized genetic cancer tests tend to overstate their supposed benefits and downplay their limitations, a new study says.

And many sites offer tests that have not been proven to be useful in guiding cancer treatment, according to the Dana-Farber Cancer Institute team that analyzed 55 such websites.

"We wanted to see if consumers are getting a balanced picture of benefits and limitations of these services," said study first author Dr. Stacy Gray in an institute news release. She is a medical oncologist and investigator at the Dana-Farber Center for Outcomes and Policy Research in Boston.

"We found a lot of variation. Some of the information is good, but all of it needs to be looked at critically by consumers and health care providers," she said.

In general, "the benefits of these personalized cancer products are reported much more frequently than are the limitations," Gray said.

The researchers also found that 88 percent of the websites offered one or more "nonstandard" tests that lacked evidence of having value in routine cancer care.

The study was published March 5 in the Journal of the National Cancer Institute.

Some sites marketed tests of a tumor's genetic characteristics, while others analyzed a patient's personal genome, or gene profile, looking for altered genes that might raise a healthy person's risk of developing cancer.

Claims and other information on websites are not regulated by agencies such as the U.S. Food and Drug Administration or the Federal Trade Commission, the researchers noted. Recently, the FDA said it intends to start regulating genetic testing more broadly.

Even if genetic testing websites become regulated, cancer specialists "will need to guide patients as they navigate decisions about personalized cancer medicine," the study authors wrote.

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Be Wary of Websites Selling Genetic Cancer Tests: Study

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We are asking people living with ALS to participate in this study by donating tissue samples and sharing your medical history. Your information will be used to characterize the disease in a way that has never been done before. Using an integrated precision medicine approach and cutting-edge technology - and YOUR help - ALS TDI will screen thousands of potential drugs for you and others like you.

As part of this study, you will be asked to donate:

As part of this study, ALS TDI will:

The sample collection site is located at MGH Dermatology Department in Boston, MA. As you know, time is the most important advantage in the battle against ALS. A local collection facility allows for the tightest control over sample transfer and quality.

To review the full experimental protocol, click here.

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What are iPS cells? - Invest in iPS @ TDI | ALS Therapy ...

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