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Center for Prevention of Progression

  • About the Center

    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.

    Precursor Blood Conditions

    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 will be cared for 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.

    Clinic Leadership

    Irene Ghobrial, MD, Director

    Irene Ghobrial, MD, specializes in care and research for multiple myeloma. She leads multiple research efforts focused on the precursor conditions of multiple myeloma — monoclonal gammopathy of undetermined significance and smoldering multiple myeloma — including the PROMISE and PCROWD studies.

    David Steensma, MD, Clinic Director

    David Steensma, MD, specializes in care and research for myelodysplastic syndromes and leukemia. He and colleagues were the first to identify and understand the clinical implications of the clonal hematopoiesis of indeterminate potential (CHIP).

    Referral Guidelines

    We welcome the opportunity to collaborate with you to evaluate and manage the care of patients with precursor hematologic conditions. To refer a patient, please call 617-582-9422.

    More information on the Center for Prevention of Progression