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ASH 2023 – latest developments in blood cancer

This weekend, more than twenty thousand experts in the field of blood cancer and other blood diseases will gather at the ASH conference in San Diego, in the United States. Doctors and researchers from the Princess Máxima Center are also attending to present their work and exchange knowledge with international colleagues. 

The ASH is the annual conference of the American Society of Hematology. Researchers from the Máxima Center will present results from 18 studies, and took part in another 20 studies on the conference program. Four PhD students from the Máxima Center have won an Abstract Achievement Award. 

Response to immunotherapy 

Joost Koedijk is doing his PhD research in the Heidenreich and Zwaan groups. He studied the functioning of the immune system against leukemia cells in people with acute myeloid leukemia (AML). ‘We mapped the spatial organization of the immune system in children and adults with AML,’ he says. ‘Where are the immune cells located, and how do they relate to each other? This gives us a better understanding of why people with AML do or do not respond to immunotherapy. This can help to estimate which children may benefit from this form of therapy. Winning the ASH Abstract Achievement Award is a great honor and recognition that we are on the right track with our research.’ 

Children with a high-risk form of acute lymphocytic leukemia, so-called BCP-ALL with a fault in the TP53 gene, have a low chance of survival compared to other children with ALL. At the ASH conference, Willem Cox, PhD candidate in the Van Leeuwen group, will present research showing that immunotherapy with CAR T-cells works less well in children with this form of high-risk BCP-ALL. Cox: ‘We showed at a cellular level why this is the case. Our results also show that other options are needed for more effective treatment of these children. In this research we had a great collaboration with colleagues in the Nierkens group, making use of their immunology expertise. I am honored that our work has been rewarded with an Abstract Achievement Award, which is a great recognition of that collaboration.’ 

Blood cells 

Two PhD students in the Van Boxtel group also won an Abstract Achievement Award. Lucca Derks carried out research into DNA changes in blood stem cells after chemotherapy treatment in children with cancer. In Vera Poort's research, she is looking for the origins of differences in the properties of leukemia cells in T-cell acute lymphocytic leukemia (T-ALL). She says: ‘We use a method to determine over time when the T-ALL cells will change. This will hopefully give us more insight into the origins of this form of leukemia in children. It is a great honor to now present the work as an oral presentation in San Diego.’ 

Revumenib 

An important late breaking abstract on the ASH program is about a trial looking at the safety and efficacy of the targeted drug revumenib, a so-called menin inhibitor. The Máxima Center was the only European research hospital to take part in this American trial of children whose leukemia has a fault in the KMT2A gene. Prof. Dr. Michel Zwaan, research group leader and head of the Trial and Data Center, led the Máxima Center's participation in this study. He says: ‘This type of drug could be very important for acute myeloid leukemia, where you see that some children with a KMT2A fault have a very poor prognosis. This fault is also commonly seen in acute lymphoblastic leukemia in babies. Menin inhibitors could in future play an important role for these children.’ 

‘In this first clinical trial of revumenib, we saw some children go into remission – that is very positive news, especially for a study in such an early phase. A trial with another menin inhibitor will soon open in the Máxima Center. Ultimately, we aim to incorporate these targeted drugs, together with chemotherapy, into the treatment protocols for AML and ALL with these genetic faults – thereby curing more children with these diseases.’