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.
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.
Research Highlights
Metformin Study
Researchers are recruiting patients with monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (MM) to understand if metformin can stabilize disease markers and thereby help reduce risk of progression to MM. Metformin is a medication that is commonly used for the treatment of diabetes, but it is considered safe for people without diabetes to take. This medication is being investigated because a number of early studies suggest it may reduce the risk of developing MM in individuals with MM precursor conditions, such as MGUS and smoldering MM.
This study is a randomized, placebo-controlled study, which means that half of the people who enroll will receive pills containing no active drug, and the other half will receive metformin. Neither the participant nor the study doctor will know which group participants are enrolled in. The treatment portion of the study will last about 6 months. If you are interested in participating or would like more information, contact the study team at precursor@partners.org, 857-202-8178.
IMPACT Study
In consideration of the urgent need for rapidly sharing discoveries that can potentially inform COVID-19 treatment decisions and prevention policies within and beyond our Center for the Prevention of Progression Clinic, Dr. Irene Ghobrial and colleagues
are launching The IMPACT Study. IMPACT is a prospective cohort study to identify the prevalence and pathogenesis of COVID-19 in individuals with precursor conditions to hematologic
malignancies and in healthy populations. It is enrolling individuals nationwide who are enrolled and prospectively followed in large cancer epidemiology and tissue banking studies at Dana-Farber. All participants enrolled in IMPACT are screened for
SARS-CoV-2 seropositivity and will then be followed and undergo additional blood collection and testing over a one year period. The overall goal of IMPACT 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, who may be at high risk of poor outcome.
CHIP
Benjamin Ebert, MD, PhD, Chair of Medical Oncology, made the landmark discovery identifying clonal hematopoiesis of indeterminate potential (CHIP), a pre-malignant state occurring in more than 10 percent of people over age 70. People with the condition
have somatic mutations associated with leukemia in cells of the blood or bone marrow, but do not meet the criteria for a hematologic cancer diagnosis. Such individuals are at significantly elevated risk (10-fold increase) of hematologic malignancy,
therapy-related leukemia, overall mortality, and cardiovascular disease.
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
PCROWD Study
Irene Ghobrial, MD, launched the PCROWD research study to collect tissue samples for patients diagnosed with precursor conditions for the purpose of understanding 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. The study has helped identify mutations associated with disease progression.
Learn more about the PCROWD study.
PROMISE Study
Ghobrial is leading this screening study of individuals at high-risk of precursor conditions of multiple myeloma, such as monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma. The goal is to establish a screening method
for high-risk individuals and to study clinical data and tissue samples to understand why some patients progress to myeloma and others do not.
Learn more about the PROMISE study.
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.