Personalized prediction scheme for myeloproliferative neoplasms developed

Researchers from the University of Cambridge, the Wellcome Sanger Institute and the Wellcome-MRC Cambridge Stem Cell Institute (all based in Cambridge, UK) have developed a personalized prediction scheme for myeloproliferative neoplasms, using new genetic and clinical information to better classify the disease.

Currently 30,000 patients in the UK alone are affected by myeloproliferative neoplasms, a group of chronic blood cancers which can progress to more severe diseases such as acute leukemia. Treatments usually aim to lessen symptoms, rather than to fully cure the disorder. The current system of classification, developed in the 1950s, splits the conditions into just three broad types.

In a study published in the New England Journal of Medicine, researchers analyzed 69 cancer genes from over 2000 patients who were affected by the disease. They discovered that these disorders can be classified into eight distinct subgroups, which were both genetically and clinically different, meaning that the discovery can have a direct impact on patient care.

Once the genetic and clinical information for each patient was combined, a personalized disease outcome prediction method was devised.

Senior author Tony Green, from the Wellcome-MRC Cambridge Stem Cell Institute and the University of Cambridge, explained: “This work represents a step change in our understanding of the myeloproliferative neoplasms. Not only does it reveal a new classification based on causal mechanisms but it also provides for the first time personally-tailored predictions to guide patient management.”

The researchers predict that their discovery will allow patients with a good prognosis to be reassured accordingly, and that more efficient and targeted therapies could be given to those with a more severe predicted outcome.

“This research proves the potential of personalized medicine, using genetics.” commented senior author Peter Campbell (Wellcome Sanger Institute), “Modern genomics will empower clinicians and support their decisions regarding the best therapies and clinical trials for each patient.”

Watch our interview with Peter Campbell:

Sanger Institute series: uncovering the genetics of cancer – interview with Peter Campbell

The data from the study also brought to light similarities between certain subgroups of myeloproliferative neoplasms and other types of blood cancer, potentially aiding future classification of blood cancers. The team believe that their new classification system could enable the testing and development of new therapeutics.

Campbell concluded: “We hope our study will be a game changer for patients with these blood cancers by providing better predictions for how their disease may behave in the future, and inform treatment choice.”

Sources: Grinfield J, Nangalia J et al. Classification and personalised prognosis in myeloproliferative neoplasms. New Engl. J. Med. doi: 10.1056/NEJMoa1716614 (2018)(Epub ahead of print); www.cancerresearchuk.org/about-cancer/other-conditions/myeloproliferative-neoplasms