Center for Prevention of Progression

Our response to COVID-19 from the Center of Prevention of Progression at Dana-Farber Cancer Institute

To better ensure your safety during this time, our team at Dana-Farber's Center for Prevention of Progression (CPOP) is taking several steps that may affect how and when you will see us for an appointment:

• We will be converting new and follow-up appointments to virtual visits whenever possible. These virtual visits will be conducted by videoconference or telephone. If we meet by videoconference, we will send you clear, easy-to-use instructions ahead of time.
• Some patients may need to delay bone marrow biopsies and/or imaging for at least several weeks, potentially longer, unless they show a specific symptom or concern. Please know that each of these delays are carefully reviewed by your care team.
• If you have a health concerns and would prefer an in-person visit, please call us at 617-632-3823 or email us at DFMyelomaReferrals@dfci.harvard.edu. We will review your health concern with your care team to determine an in-person visit is needed and how quickly that can take place.

If you have additional questions, email us at precursor@partners.org

We wish you and your families the best in this challenging time.

The Center for Prevention of Progression is the first-of-its-kind clinic for patients with precursor conditions of hematologic malignancies. Building on Dana-Farber's past and ongoing research efforts of precursor conditions, the clinic evaluates individuals diagnosed with these conditions or at high risk for disease development, and works with patients to manage their risk of disease progression.

Our goal is to increase early detection and improve treatment options for precursor conditions, so we can prevent these conditions from developing into blood cancers which are often incurable, or from resulting in other complications such as cardiovascular death or organ dysfunction.

As with many solid tumors, some blood cancers are preceded by precursor conditions. These conditions are sometimes found through routine blood tests, but often remain undiagnosed. Precursor blood conditions include:

• Clonal hematopoiesis of indeterminate potential (CHIP): Increases risk of myelodysplastic syndromes (MDS), acute myeloid leukemia (AML), myeloproliferative neoplasms, lymphoid malignancies, and cardiovascular disease
• Clonal cytopenias of undetermined significance (CCUS): Increases risk of MDS or AML
• Monoclonal gammopathy of undetermined significance (MGUS): Increases risk of multiple myeloma, lymphoma, or Waldenström's macroglobulinemia
• Smoldering multiple myeloma (SMM): Increases risk of multiple myeloma
• Early (lower-risk) myelodysplastic syndromes (MDS): Increases risk of higher-risk and acute myeloid leukemia
• Monoclonal B cell lymphocytosis (MBL): Increases risk of chronic lymphocytic leukemia (CLL)

Certain individuals are at higher risk for these conditions and should consider screening and counseling at the Center. These include:

• Individuals with minor blood count abnormalities without other features of a specific disease.
• Individuals with a first-degree relative with multiple myeloma or B-cell malignancies are three times more likely to have a precursor blood condition.

Patients are cared for by a multidisciplinary team that harnesses Dana-Farber's leadership and expertise in hematologic malignancies, genetic risk and prevention. This includes hematologists/oncologists who specialize in a patient's specific precursor condition, as well as specialists in genetic risk and prevention, genetic counseling, psychosocial support, and other specialties as needed.