{"id":47547,"date":"2000-02-02T00:00:00","date_gmt":"2000-02-02T06:00:00","guid":{"rendered":"https:\/\/www.unmc.edu\/newsroom\/2000\/02\/02\/discovery-may-give-physicians-more-tools-for-predictingpatients-prognosis\/"},"modified":"2022-08-29T10:56:06","modified_gmt":"2022-08-29T15:56:06","slug":"discovery-may-give-physicians-more-tools-for-predictingpatients-prognosis","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/newsroom\/2000\/02\/02\/discovery-may-give-physicians-more-tools-for-predictingpatients-prognosis\/","title":{"rendered":"Discovery May Give Physicians More Tools for Predicting\n\nPatient’s Prognosis;"},"content":{"rendered":"

<\/FONT><\/U><\/I><\/p>\n


UNMC,  National Researchers Discover Common Cancer<\/p>\n

is Two Distinct Diseases<\/FONT><\/B><\/p>\n

For pathologists, distinguishing among the many types of B-cell lymphoma<\/p>\n

has always been a challenge.  Current tumor classification systems<\/p>\n

are based on subtle differences in the appearance of these immune cells<\/p>\n

under a microscope, leaving many to wonder whether looks sometimes might<\/p>\n

be deceiving.<\/p>\n

But today in the weekly international journal, Nature, a team of scientists<\/p>\n

report that in the future, there may be a new way around this old problem.<\/p>\n

Using DNA microarray technology — a powerful new research tool that can<\/p>\n

record the expression patterns of thousands of genes at once — the group<\/p>\n

was able to show that, as currently defined, diffuse large B-cell lymphoma,<\/p>\n

the most common form of non-Hodgkins lymphoma is actually two distinct<\/p>\n

diseases.<\/p>\n

Researchers at the University of Nebraska Medical Center, and collaborators<\/p>\n

from five other institutions across the United States, say this information<\/p>\n

may ultimately be used to predict the prognosis of patients with lymphoma.<\/p>\n

Besides UNMC, other institutions involved in the research include: the<\/p>\n

National Institutes of Health, Washington, D.C.; Stanford University School<\/p>\n

of Medicine in Palo Alto, Calif.; Research Genetics in Huntsville, Ala;<\/p>\n

Johns Hopkins School of Medicine in Baltimore; and Walter Reed Army Medical<\/p>\n

Center in Washington, D.C.<\/p>\n

Through this pilot project, we believe that genetic profiling will<\/p>\n

be able to predict which lymphoma will have a good or poor prognosis for<\/p>\n

the patient, said Wing (John) Chan, M.D., a pathologist and professor<\/p>\n

in the UNMC Department of Pathology and Microbiology. Dr. Chan is principal<\/p>\n

investigator of the grant at UNMC. One type of tumor may require aggressive<\/p>\n

treatment while another may require less aggressive treatment, which would<\/p>\n

reduce the potential complications involved with treatment. If we can find<\/p>\n

out the genetic factors that determine prognosis and response to treatment,<\/p>\n

then we may be able to use this information as a target to design new therapies<\/p>\n

to attack the disease, Dr. Chan said.<\/p>\n

Louis Staudt, M.D., Ph.D., a scientist at the National Cancer Institute<\/p>\n

(NCI) and the senior author on the paper, said this finding helps to explain<\/p>\n

why about 40 percent of patients with this type of NHL can be cured with<\/p>\n

standard chemotherapy regimens, while other patients who seemingly have<\/p>\n

the same disease often relapse.  Its a case of mistaken identity,<\/p>\n

Dr. Staudt said.  The tumor cells might look very similar, but this<\/p>\n

study offers strong<\/p>\n


evidence that their molecular engines work very differently.<\/p>\n

This weeks paper also adds to the growing interest among scientists<\/p>\n

to create molecular profiles of common cancers.  This finding offers<\/p>\n

one of the first glimpses into how cancer will be diagnosed in the future,<\/p>\n

said NCI Director Richard Klausner, M.D. It will be based on well-characterized<\/p>\n

biological differences among tumor cells that tell us more precisely how<\/p>\n

aggressive a tumor will be and how best to treat it.<\/p>\n

As the experiments proceeded, the scientists discovered something interesting.<\/p>\n

The diffuse large B-cell lymphoma (DLBCL) samples showed distinct differences<\/p>\n

in their expression of hundreds of genes, suggesting that DLBCL might be<\/p>\n

more than one cancer.<\/p>\n

An analysis showed two distinct patterns of gene expression, signifying<\/p>\n

that they were looking at two subtypes of the cancer.  In one of the<\/p>\n

subtypes, called GC B-like, the expression of germinal center genes was<\/p>\n

largely congruent with that of normal B cells. But in the second subtype,<\/p>\n

known as activated B-like, these genes were expressed at low or undetectable<\/p>\n

levels. This finding that the subtypes express germinal center genes<\/p>\n

differently–pointed to major biological differences among them.<\/p>\n

In a pilot study of 42 previously untreated DLBCL patients who were<\/p>\n

being treated with anthracycline-based chemotherapeutic regimens, the scientists<\/p>\n

discovered significant differences in five-year survival rates among the<\/p>\n

subtypes.  For patients with GC B-like, three-fourths were alive<\/p>\n

at the five-year mark; for activated B-like, only 16 percent were still<\/p>\n

living.<\/p>\n

Ron Levy, M.D., an author on the paper and a scientist at the Stanford<\/p>\n

University Medical Center, agrees. As this finding shows, genetic profiling<\/p>\n

of tumors will offer extra power in predicting which patients will do well<\/p>\n

and which will do poorly, he said. This more precise diagnosis of a developing<\/p>\n

cancer should help in the future in more accurately guiding a patients<\/p>\n

treatment decisions.<\/p>\n

A five-year, $3.24 million grant was funded by the NIH at UNMC and collaborating<\/p>\n

insititutions to verify and extend the groups finding, a standard practice<\/p>\n

in science.  Diffuse large B-cell lymphoma is diagnosed in over 25,000<\/p>\n

Americans each year.  At a time when many cancers are decreasing in<\/p>\n

the United States, this lymphoma is increasing, making it a growing public<\/p>\n

health concern.<\/p>\n

The study also prompted a planned expansion of involvement from three<\/p>\n

institutions in the United States and Canada to potentially eight in the<\/p>\n

U.S., Canada and Europe. To confirm our initial finding, we need to have<\/p>\n

a large number of cases to study. This would give us statistical power<\/p>\n

to get a more firm conclusion, Dr. Chan said.<\/p>\n

Four other UNMC researchers and clinicians also are involved in the<\/p>\n

study. They are Timothy Greiner, M.D., Dennis Weisenburger, Ph.D., James<\/p>\n

O. Armitage, M.D., and James Lynch, Ph.D.<\/p>\n

UNMC is the only public academic health science center in the state.<\/p>\n

Through its commitment to research, education, outreach and patient care,<\/p>\n

UNMC has established itself as one of the country’s leading centers for<\/p>\n

cancer research and treatment, solid organ transplantation and arthritis.<\/p>\n

Nearly $32 million in research grants and contracts were awarded to UNMC<\/p>\n

scientists during the past fiscal year. In addition, UNMCs educational<\/p>\n

programs are responsible for training more health professionals practicing<\/p>\n

in Nebraska than any other institution.<\/p>\n


 <\/p>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"

UNMC,  National Researchers Discover Common Cancer is Two Distinct Diseases For pathologists, distinguishing among the many types of B-cell lymphoma has always been a challenge.  Current tumor classification systems are based on subtle differences in the appearance of these immune cells under a microscope, leaving many to wonder whether looks sometimes might be deceiving. But […]<\/p>\n","protected":false},"author":79,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-47547","post","type-post","status-publish","format-standard","hentry","category-uncategorized","department-press-release"],"yoast_head":"\nDiscovery May Give Physicians More Tools for Predicting Patient's Prognosis;<\/title>\n<meta name=\"description\" content=\"UNMC,  National Researchers Discover Common Cancer is Two Distinct Diseases For pathologists, distinguishing 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