DNA Damage From Chemo May Help Spur Leukemia’s Return

THURSDAY, Jan. 12 (HealthDay News) — The chemotherapy used to
treat a form of adult leukemia sets a trap that can result in the return
of the disease within years, a new study suggests.

The finding confirms the suspicions of specialists who thought
chemotherapy drugs could disrupt DNA through mutations and ultimately
allow tumor cells to avoid the effects of the medications.

Chemotherapy drugs are absolutely necessary to get leukemia patients
into remission, but we also pay a price in terms of DNA damage,” study
co-author Dr. Timothy Ley, a professor of oncology at Washington
University School of Medicine in St. Louis, said in a university news
release.

These drugs “may contribute to disease progression and relapse in many
different cancers, which is why our long-term goal is to find targeted
therapies based on the mutations specific to a patient’s cancer, rather
than use drugs that further damage DNA,” Ley added.

The type of leukemia in question is known as acute myeloid leukemia.
While chemotherapy treatment can send the cancer into remission, 80
percent of patients die within five years. In the United States, about
13,000 cases of acute myeloid leukemia are diagnosed annually, most often
in people age 60 and older.

The researchers came to their conclusions after studying the genomes —
the entire DNA, both healthy and cancerous cells — from eight patients
with acute myeloid leukemia. They watched to see what happened after the
patients received chemotherapy.

The investigators found that tumors essentially reappeared, according
to the report published in the Jan. 11 advance online edition of
Nature.

“It’s the same tumor coming back but with a twist,” co-author Richard
Wilson, director of university’s Genome Institute, explained in the news
release. It “comes back with new mutations that give the cells new
strategies for surviving attack by whatever drugs are thrown at them. This
makes a lot of sense but it’s been hard to prove without whole-genome
sequencing.”

Commenting on the report, Louis DeGennaro, executive vice president and
chief mission officer of the Leukemia Lymphoma Society, said the
study “demonstrates the critical need to identify disease-causing
mutations in acute myeloid leukemia so that therapies targeted
specifically at these mutations can be developed.”

Ultimately, he added, “that would allow us to avoid the use of
chemotherapy, which may contribute to cancer relapse.”

For now, DeGennaro said, “while current chemotherapy regimens have
liabilities, they represent the best treatment currently available and may
result in complete remission, which would allow eligible patients to
receive a stem cell transplant, the only treatment capable of curing acute
myeloid leukemia.”

More information

For more about acute myeloid leukemia, visit the U.S. National Library
of Medicine.

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