Center for Prevention of Progression

Dana-Farber has been a leader in the research of precursor hematologic conditions for many years. Our team is committed to early detection and intervention to prevent progression to incurable blood cancers. As part of the Center for Prevention of Progression clinic, patients have the opportunity to participate in clinical trials and research evaluating prevention strategies.

Current Clinical Trials

Metformin Study

For patients with monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (MM), this study evaluates if metformin can stabilize disease markers and help reduce risk of progression to MM. Metformin is a medication that is commonly used to treat diabetes, but is considered safe for people without diabetes to take. A number of early studies have suggested that metformin may reduce the risk of developing MM in individuals with MM precursor conditions, such as MGUS and smoldering MM.

IMPACT Study

IMPACT is a prospective study to identify the prevalence and pathogenesis of COVID-19 in individuals with precursor conditions to hematologic malignancies and in healthy populations. The goal is to understand the short- and long-term impact of COVID-19 on the immune system of healthy individuals and individuals with underlying immune dysregulation (such as those with precursor conditions), who may be at high risk of poor outcome. Participants will be screened for SARS-CoV-2 seropositivity and will then be followed and undergo additional blood collection and testing for one year.

PCROWD Study

The PCROWD research study collects tissue samples for patients diagnosed with precursor conditions in order to understand the progression and clonal evolution of blood cancers, with the ultimate aim of developing targeted therapeutic agents that can eliminate the early clones of disease and prevent progression to cancer. The study has helped identify mutations associated with disease progression. Patients with any precursor blood cancer condition are eligible to participate in the PCROWD study.
Learn more about the PCROWD study.

PROMISE Study

Promise is a screening study for individuals at high-risk of precursor conditions of multiple myeloma, such as monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). The goal of this study is to establish a screening method for high-risk individuals and to gather data that helps us understand why some patients progress to myeloma and others do not. Eligible individuals include:

• African Americans and/or
• Individuals of any race who have a parent, sibling, or child with:
  • Multiple myeloma
  • Another blood cancer
  • MGUS
  • Smoldering multiple myeloma
  • Waldenström's macroglobulinemia

Research Highlights

Our team was the first to discover CHIP and its link to blood cancers and cardiovascular disease, and has been leading several efforts to understand the genomic, genetic, and epigenetic factors that influence disease progression for other precursor conditions. We offer several clinical trials of early therapeutic intervention to prevent progression and cure the disease in its early state.

Clonal hematopoiesis of indeterminate potential (CHIP)

Benjamin Ebert, MD, PhD, Chair of Medical Oncology, made the landmark discovery identifying clonal hematopoiesis of indeterminate potential (CHIP), a precursor condition that is detectable in over 10 percent of people over age 70, and was the first to describe the increased risk of blood cancers and cardiovascular disease in people with CHIP.

Age-related clonal hematopoiesis linked to adverse outcomes, New England Journal of Medicine, 2014 November 26
Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes, Blood, 2015

Smoldering Multiple Myeloma

Nikhil Munshi, MD, and his colleagues have identified the genomic changes that occur as smoldering multiple myeloma (SMM) advances to myeloma. Their findings lay the groundwork for tests that can identify patients whose SMM is likely to progress rapidly to myeloma, and who could benefit from prompt treatment.