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MSK PATHOLOGY Initiatives Innovations REVIEW Accomplishments 4Th Quarter 2019

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MSK PATHOLOGY Initiatives Innovations REVIEW Accomplishments 4Th Quarter 2019 MSK PATHOLOGY Initiatives Innovations REVIEW Accomplishments 4th Quarter 2019 A Journey of Technological Evolution in Research and Diagnostics Commentary from the Department Chair Case of the Quarter CASE HISTORY 59 year old woman with palpable and tender 3.5 cm right lateral breast With this issue of the MSK Pathology Review, mass and weight loss and no axillary we resume the publication of our departmental lymphadenopathy. Of note, she quarterly newsletter after a 6 month hiatus. The lack presented with a 1.6 cm right upper of intervening issues has a simple explanation. Our lobe lung mass. Both biopsies are talented science writer, Hope Cristol, decided to move shown here. The patient ultimately on to new opportunities, and it took us quite some underwent mastectomy due to rapid Breast, biopsy time to find a replacement. Finally, we were fortunate growth of the breast mass. to find Onward Publishing, Inc., a professional writing group that has assigned several different The correct diagnosis will be writers to assist us with our production. Meanwhile, provided in the next issue of the MSK Sarah Virgo has continued to collect material and Pathology Review and on Twitter at ideas for stories. The current issue is among our @MSKPathology most comprehensive to date, including updates on Scan the QR code to view digital slides events over the past 6 months along with continuing available on mskcc.pathpresenter.com our series on diagnostic teams, individual faculty investigators, and fellows’milestones. We introduce a “Case of the Quarter” feature and highlight the quality Lung, biopsy improvement efforts throughout the department. Clearly, the MSK Pathology Review is back on track, and the continuing accomplishments and innovations from our department ensure we will have plentiful material for many issues to come! I would like to take this opportunity to acknowledge those who have contributed so much to this project – Hope Cristol, Allix Mazzella, Jordana Shapiro, and of course Sarah Breast, excision (10x) Virgo, whose investment in this effort is absolutely key to its success. I hope you will all enjoy this new edition! - David Klimstra, MD Breast, excision (100x) MSK PATHOLOGY MSK PATHOLOGY 2 REVIEW 4th Quarter 2019 REVIEW 4th Quarter 2019 3 Research Profile WENBIN XIAO, MD The current World Health Organization “(WHO) classification is ‘mostly based on morphology and history, and integrates some genetic data. For nearly half of the AML, the genetic information is still not utilized to classify disease.’” subclasses of AML. Among the subclasses, pathogenesis of ALMED. Xiao and colleagues mutations including PHF6 and RUNX1. “The core-binding factor AML tends to have were the first to explore the disease’s mutations of these two molecules probably a good prognosis. However, it can turn mechanisms of pathogenesis in humans and comprise about 60% of secondary AML into aggressive disease if it gains genomic concluded that the mechanism of pathogenesis cases,” he says. mutations over time. Xiao was the lead in humans is similar to that in animals. Xiao’s studies have relied on clinical author of a 2017 study, published in Blood His recent work also identified PHF6 and data. However, he has recently moved back Advances, in which a patient with inv(16) DNMT3A mutations in mixed phenotype to the bench, joining the lab of Ross Levine, For a relatively new Some MSK pathologists prefer the clinical strong research interest kept tugging at him AML achieved five complete remissions acute leukemia, a rare type of leukemia MD, the Laurence Joseph Dineen Chair in hematopathologist, Dr. Xiao side of their responsibilities; others are and soon he was back at the bench. with various chemotherapies but ultimately often challenging to diagnose. The findings, Leukemia Research and Chief of Molecular already has remarkable primarily researchers. Hematopathologist died from this aggressive and highly invasive published in Blood Advances in 2019, showed Cancer Medicine with the Human Oncology Wenbin Xiao prefers both. Instead of splitting STUDIES ON AML disease. Bone marrow biopsies performed a phenotype-genotype correlation between and Pathogenesis Program (HOPP). “I will research experience. his time evenly between them, his career has For the past three years, Xiao has been at each relapse revealed a consistent gain in mutations and mixed phenotype, which can apply my findings from the clinical side and focused primarily on either one or the other working to better classify hematological cytogenetic abnormalities and a KRASG12D use this knowledge to make mouse models to By Hope Cristol potentially facilitate the diagnosis. at different times. malignancies at the genetic level – especially mutation. Although unusual, this unique More recently, Xiao reported at the ASH learn about the mechanisms of the disease,” After completing his MD/PhD training, secondary acute myeloid leukemia (AML). case highlights how acquired genomic meeting a subset of AML patients showing Xiao says. Xiao spent six years doing bench work, first He cowrote a seminal review of the genetic alterations can quickly alter prognosis, even RUNX1 mutations and plasmacytoid Treatments for secondary AML are not as a postdoc and then as a research scientist. basis of hematologic malignancies, published for a chemosensitive patient. dendritic cell differentiation, a rare cell type adequate and disease prognosis is poor. This “At that time, my research was mostly focused in Blood. The current World Health Another study, published in Leukemia normally responsible for host immunity is partly because molecular targets have not on signal transduction in leukemic cells,” Xiao Organization (WHO) classification is “mostly in 2018, focused on an extremely rare and against viral infection. Accurate diagnosis yet been identified. Also, the disease usually says. “But I was trained as a physician, so I based on morphology, history, and integrates aggressive subclass: acute leukemia with of this AML variant may benefit the patients strikes people later in life who “cannot wanted to get involved in patient care as well.” some genetic data. For nearly half of the AML, megakaryocytic and erythroid differentiation from appropriate targeted therapies. tolerate regular cytotoxic chemotherapy. He returned to medicine, completing his the genetic information is still not utilized to (ALMED). The patient could die from complications,” residency and fellowship and then joined the classify disease”, Xiao says. Previous research in mice suggested a EVOLVING RESEARCH ROLE Xiao says. “So we need to find better targeted staff at MSK. For a while, much of his work Several of his recently published studies cooperative role of JAK/MAP kinase pathway Xiao continues to focus on secondary therapy, which means we need to find those was on the clinical side of pathology. But his explored the genetic underpinnings of rare activation and TP53 mutations in the AML and is adding to the evidence on targets.” MSK PATHOLOGY MSK PATHOLOGY 4 REVIEW 4th Quarter 2019 REVIEW 4th Quarter 2019 5 genomic pathology, and mass spectrometry-driven proteomics. He THE FOURTH ANNUAL gave a lecture entitled “Mass Spectrometry as a Driver for Discovery in Lymphoma Pathogenesis.” SYMPOSIUM Dr. Elenitoba-Johnson is also the founding director of Penn Medicine’s Center for Personalized Diagnostics and chief of the IN TRANSLATIONAL Division of Molecular and Genomic Pathology at Penn Medicine. Attendees were welcomed to the symposium by Dr. David Klimstra, RESEARCH IN PATHOLOGY Chair of the Department of Pathology. Several other pathologists from Honors William L. Gerard Award the department gave presentations on a range of topics, including Winner and Highlights Cutting-Edge sample preparation, the role of fusion genes, and assessing minimal residual disease (see page 9 for a full lecture schedule). Pathology Research The Gerald Award was created to recognize the contributions and values brought to MSK’s Department of Pathology by William L. By Julie Grisham Gerald, who died in 2008. Dr. Gerald was a pioneer in the molecular characterization of cancer at a time when now-commonplace molecular techniques were still cutting-edge technology. Throughout On March 28, Memorial Sloan Kettering’s Department of his career, he provided mentorship and collaboration to numerous Pathology hosted its Fourth Annual Symposium in Translational trainees and colleagues. The award is a tribute to his scientific Research in Pathology. The event, which included the presentation contributions and personal attributes and to the legacy of his work of the William L. Gerald Award, was held in the Zuckerman Research in the department. Laboratory Auditorium. Past recipients of the Gerald Award include Drs. Arul Chinnaiyan The winner of this year’s Gerald Award was Kojo Elenitoba- of the University of Michigan Medical School, David Huntsman of the Johnson, the Peter C. Nowell MD Professor at the Perelman School University of British Columbia, Adrienne Flanagan of the University of Medicine at University of Pennsylvania. Dr. Elenitoba-Johnson is an College London Cancer Institute, and A. John Iafrate of Massachusetts international leader in the fields of hematopathology, molecular and General Hospital and Harvard Medical School. William L. Gerald, MD PhD MSK PATHOLOGY MSK PATHOLOGY 6 REVIEW 4th Quarter 2019 REVIEW 4th Quarter 2019 7 in 2006. He is an elected member of the KOJO ELENITOBA-JOHNSON, MD American Society for Clinical Investigation Professor, Perelman School of Medicine
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