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2012 Hematologic Oncology Annual Report

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2012 Hematologic Oncology Annual Report Hematologic Oncology 2012 ANNUAL REPORT Contents Letter from the Division Head . 1 Events Hematologic Oncology Team . 2 American Society of Hematology Annual Meeting . 11 Patient Care The Mortimer J . Lacher Fellows Conference . 11 Making Cell-Based Therapies Safer Hematologic Oncology Nurses Represent MSK and More Effective . 4 at National Meetings . 12 Five Facts about Stem Cell Transplantation Stem Cell Transplant Survivors Celebration . 12 and How to Become a Donor . 5 Appointments and Promotions . 13 Patient Story: Clinical Training and Education . 14 A Team Approach to Tackling a Rare Cancer . 6 Fundraising Overview of Centers and Programs . 7 Swim Across America . 15 Expanding Our Program . 7 Stand Up to Cancer Dream Team . 15 Interview with Martin S. Tallman . 8 Fred’s Team . 16 Research Cycle for Survival . 16 Investigators Discover Why Some Leukemia Drugs Publications . 17 Are Not Sufficiently Effective . 9 Philanthropic Donors . 19 Helping the Thymus Bounce Back . 10 You Can Help . 19 ON THE COVER [LEFT] DR. REKHA PARAMESWARAN, MD ASSOCIATE ATTENDING, HEMATOLOGY SERVICE [RIGHT] DR. ROSS LEVINE, MD ASSOCIATE ATTENDING, LEUKEMIA SERVICE Letter from the Division Head The Division of Hematologic Oncology is 2012 Hematologic Oncology Facts and Figures one of the largest programs in the United States dedicated to caring for people with New Visits/ Initial Encounters Follow-Ups Total hematologic cancers. We are also home Outpatient 3,923 35,662 39,585 to the nation’s largest fellowship program Inpatient 1,957 31,300 33,257 for Medical Hematology/Oncology. In 2012, we expanded our clinical program Adult Bone Marrow Transplants (Table I). We recruited three new faculty members and established a new service Allogeneic 157 devoted to Multiple Myeloma. Our clinical research continues to grow Autologous 243 and our outstanding laboratory-based research has resulted in novel Total 400 approaches, including an improved classification of Acute Myeloid Leukemia and a breakthrough therapy with genetically modified T cells Clinical Trial Accruals for Acute Lymphoblastic Leukemia. In this Annual Report, we have 600 highlighted a few of our accomplishments. 500 400 300 488 513 200 339 308 279 100 0 2008 2009 2010 2011 2012 Marcel R.M. van den Brink, MD, PhD Alan Houghton Chair in Immunology Head, Division of Hematologic Oncology 1 Hematologic Oncology Team ADULT BONE MARROW TRANSPLANTATION Juliet Hugo David Parastoo Sergio Jenna Alan Barker Castro-Malaspina Chung Dahi* Giralt Goldberg Hanash Katharine Ann Robert Guenther Heather Esperanza Miguel Hsu Jakubowski Jenq Koehne Landau Papadopoulos Perales HEMATOLOGY Doris Craig Roni Marcel James Simon Rekha Ponce Sauter Tamari* van den Brink Young Mantha Parameswaran LEUKEMIA Lilian Gerald Omar Ellin Renier Stephen Bayard Reich Soff Abdel-Wahab Berman Brentjens Chung Clarkson Marco Dan Faye Virginia Ross Peter Michael Davila Douer Feller* Klimek Levine Maslak Mauro* Jae Raajit David Alan Eytan Martin Park Rampal* Scheinberg Shih* Stein* Tallman CONTINUED ON PAGE 3 2 CONTINUED FROM PAGE 2 HEMATOLOGIC ONCOLOGY TEAM LYMPHOMA COLLABORATING TEAMS • Cardiology Service • Case Management • Colorectal Service • Critical Care Medicine Service • Dental Service Helen John Paul Steven Chung Gerecitano Hamlin Horwitz • Dermatology Service • Endocrinology Service • Gastroenterology and Nutrition Service • Gastric and Mixed Tumor Service • General Internal Medicine Service • Geriatrics Service • Gynecology Service • Head and Neck Service Matthew Alison Craig Ariela • Hepatopancreatobiliary Service Matasar Moskowitz Moskowitz Noy • Infectious Diseases Service • Integrative Medicine Service • Interventional Radiology Service • Music/Art Therapy • Neurology Service • Neurosurgery • Nursing Lia Carol David Andrew • Nutrition Palomba Portlock Straus Zelenetz • Occupational Therapy • Ophthalmic Oncology Service MYELOMA • Orthopaedic Service • Pain and Palliative Care Service • Pathology • Diagnostic Molecular Pathology • Hematopathology Anas Hani Nikoletta Alexander • Pathology Diagnostic Services, Cytology Younes* Hassoun Lendvai Lesokhin • Surgical Pathology Diagnostic Services - Bone and Soft Tissue Pathology REGIONAL NETWORK - Dermatopathology - Gastrointestinal Pathology • Physical Therapy • Plastic and Reconstructive Surgical Service • Psychiatry Service Philip C . Pamela R . Audrey M . • Pulmonary Service Caron Drullinsky Hamilton • Radiation Oncology • Radiology • Rehabilitation Medicine Service • Renal Service • Social Work • Surgery • Thoracic Service • Urgent Care Center • Urology Service * Joined faculty in 2013 3 PATIENT CARE Making Cell-Based Therapies Safer and More Effective Cell-based therapies are highly personalized approaches which New Hope for a Challenging Leukemia harness the power of each Researchers on the Leukemia Service, patient’s immune system to led by Renier Brentjens and Marco attack and kill cancer cells. As Davila, reported in Science Translational Medicine the first results of a cell- targeted as they are, however, based therapy evaluated in a clinical they may also cause side trial of adults with relapsed B-cell acute lymphoblastic leukemia (B-ALL), a DR. MICHEL SADELAIN AND DR. RENIER effects by harming normal disease that carries a dismal prognosis. BRENTJENS cells. Memorial Sloan Kettering Using a disabled virus, the scientists introduced new genetic material into investigators developed a new in the laboratory; and then the enhanced T cells are given back to the patient to seek out T cells removed from the patients, technique to generate more and attack cancer cells. reprogramming them to recognize and destroy cells expressing the CD19 specific cell-based immune Cancer cells overproduce certain antigens, which can help T cells to recognize them, protein on B-ALL cells. Remarkably, therapies for cancer that may but those same antigens are often found in all five patients described in the report achieved a remission, with be safer and more effective. lower levels on healthy cells. “There are very few antigens, if any, that are found only on no molecular evidence of leukemia. Cell-based therapies make use of patients’ cancer cells,” Dr. Sadelain explains. “This Four of the patients were then able own immune cells that have been enhanced means that T cells engineered to recognize to go on to a potentially curative bone in the laboratory. They have shown early a certain antigen could attack normal cells marrow transplant. The Leukemia success for treating blood cancers, including that have that same antigen as well.” Service is continuing to enroll patients certain types of leukemia. One challenge, Through the latest approach, scientists from around the country in this however, has remained: It has been difficult at MSK have learned to modify a patient’s groundbreaking clinical trial. for investigators to train immune cells T cells to recognize two antigens. “We can to attack cancer cells without damaging create T cells that recognize two different normal, healthy cells in the body with antigens found on the tumor cell — a In a study published online December some of the same features. “We are getting signature unique to that type of cancer — 16, 2012 in Nature Biotechnology, the better at working with patients’ immune and only attack cells with both antigens, team reported creating T cells that carried cells and enhancing them to achieve a sparing the normal cells that express either receptors for two antigens in prostate cancer powerful immunological response against antigen alone,” Dr. Sadelain adds. cells: a CAR for an antigen called PSMA cancer,” says Michel Sadelain, Director of The new technique makes use of two and a CCR for an antigen called PSCA. Memorial Sloan Kettering’s Center for Cell kinds of receptors: chimeric antigen The investigators then generated mouse Engineering, who led the research. “Our receptors (CARs), which allow T cells to models of prostate cancer and infused the goal now is to avoid potentially harmful target antigens on the surface of a tumor mice with the engineered cells. They found side effects.” cell, and chimeric costimulatory receptors that the T cells attacked only tumors that Investigators use adoptive cell transfer (CCRs), which allow T cells to recognize carried both antigens. (ACT) to engineer white blood cells, called a second antigen. CAR and CCR work “We are the first to evaluate this T cells, to recognize a certain antigen on together through a process known as concept and show that it works,” Dr. the surface of a cancer cell and mount “balanced signaling,” in which the presence Sadelain concludes. “We plan to develop an immune response. These T cells are of either antigen on its own is not enough clinical trials based on this approach. removed from the patient; a gene is added to trigger the immune response. As a result, Ultimately, our goal is to create targeted in the laboratory to allow them to recognize only tumor cells that carry both antigens will immunotherapies that are both potent and the antigen; the modified T cells are grown be targeted. safe for patients.” 4 PATIENT CARE Five Facts about Stem Cell Transplantation And How to Become a Donor Over the course of three decades, Memorial Sloan Kettering physicians have performed more than 4,000 bone marrow transplants — nearly 400 annually in DR. SERGIO GIRALT, DR. MARCEL VAN DEN BRINK, DR. JULIET BARKER, DR. GUENTHER KOEHNE recent years. stem cells in their bone marrow. Healthy with a lower risk of developing an infection. In 1973, Memorial Sloan Kettering doctors blood
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