Leukemia and Lymphoma Experts Join Center for Blood Cancers

With the recent addition of the Leukemia Service and the Center for Lymphoid Malignancies, Columbia’s Center for Blood Cancers now has a full complement of world-renowned experts in every form of blood cancer treatment and research. 

“It’s critical to have physicians with expertise in a wide variety of blood cancers, not just one or two,” says Stephen Emerson, MD, PhD, director of the Herbert Irving Comprehensive Cancer Center. “In patients with complicated blood disorders, the distinctions can be very subtle. To provide the very best care which incorporates the rapidly advancing genetic and molecular characterization of these rare diseases it is essential to have physician scientists with a focused expertise in each area.”

“If you have a serious illness with an uncertain course, you want to go to a place where the person caring for you has a finger on the pulse of research,” says Donald Landry, MD, PhD, chair of the Department of Medicine at P&S. “Our experts not only have experience with cancers that are quite rare, but specialize in their research and treatment.” 

Patients at the new Center for Lymphoid Malignancies, for example, are cared for by a group of clinician-researchers, nurses, and support staff who are experienced with standard treatment options and can offer the latest investigational therapies.

“We have the world’s largest portfolio of new drugs for patients with all forms of lymphoma, which gives patients unparalleled options,” says Owen A. O’Connor, MD, PhD, the center’s director. “The center is constructed so that the clinical and research missions are integrated—the same nurse that treats you with traditional chemotherapy on one day administers an experimental protocol on another day. The nurse is familiar with your care and case history which, in this way, ensures complete patient continuity.”

Many of the investigational (and even FDA-approved) treatments available at the center have been developed by the center’s own physician-scientists. Dr. O’Connor developed vorinostat, the first histone deacetylase inhibitor approved by the FDA for the treatment of cancer (in 2005), and bortezomib, the first protease inhibitor treatment for mantle cell lymphoma (approved in 2006). More recently, he co-invented and developed pralatrexate, the first FDA-approved drug for the treatment of patients with relapsed or refractory peripheral T-cell lymphoma. Pralatrexate is now being approved around the world.

In collaboration with Dr. Landry, his latest research is focusing on a new class of drugs that target NF-κB, a “master regulator” that drives the misbehavior of cancer cells in many malignancies, including lymphoma, breast cancer, and prostate cancer. “We hope that we can soon move these drugs into the clinic,” says Dr. O’Connor. 

Clinical care and research are also intertwined in the blood cancer center’s new leukemia service, a five-physician group recruited from Memorial Sloan-Kettering Cancer Center. 

The Center for Lymphoid Malignancies and the Leukemia Service join three other units of the Center for Blood Cancers: the blood and marrow transplant unit, led by Markus Mapara, MD, PhD; the multiple myeloma/amyloidosis group, led by Suzanne Lentzsch, MD, PhD; and the myelodysplastic syndrome group, led by Azra Raza, MD. 

“Columbia’s always had fantastic basic science with a real commitment to growing clinical programs,” says one of the five new recruits, Joseph Jurcic, MD, director of hematologic malignancies. “Drs. O’Connor and Raza are international figures in lymphoma and myelodysplastic syndrome. Eight months before we arrived, Columbia recruited Dr. Mapara to head the bone marrow transplant program and Dr. Lentzsch, an international expert in multiple myeloma and amyloidosis. All of the pieces were coming together and the only thing that was missing was expertise in leukemia. Now we have the critical mass needed to treat patients with hematologic malignancies and really make a difference in the field—it’s an exciting time.”

Physicians within the leukemia group treat patients with all forms of leukemia, myelodysplastic syndrome, and myeloproliferative neoplasms, such as chronic myeloid leukemia. Mark L. Heaney, MD, PhD. specializes in other rare forms of leukemia, such as hairy cell leukemia, large granular lymphocyte leukemia, and hypereosinophilic syndromes. Todd Rosenblat, MD, treats patients with acute and chronic leukemias, myeloproliferative neoplasms, and myelodysplastic syndrome with a research focus in acute myeloid leukemia. Nicole Lamanna, MD, is a recognized leader in the treatment and clinical investigation of patients with chronic lymphocytic leukemia. Her research focuses on the development of combination therapies that include chemoimmunotherapy, immunomodulatory drugs, novel kinase inhibitors, and monoclonal antibodies. Through her research she is working to find more active, safer therapies for older patients with this disease. 

Some investigational therapies under development in the group’s laboratories have entered or are nearly ready for clinical trials. A novel therapy for acute myeloid leukemia, developed by Dr. Jurcic, uses antibodies to deliver a deadly radioactive payload directly to leukemia cells while sparing nearby healthy cells. 

In addition to the expertise of Mark Frattini, MD, PhD, in treating leukemias is the development in his laboratory of a novel drug (MSK-777). This drug, designed to inhibit Cdc7 kinase, a novel signal transduction pathway to which many cancers are addicted, is on track to enter clinical trials in early 2014 with partial funding support from the Leukemia & Lymphoma Society’s Therapy Acceleration Program. “This molecule is extremely selective for cancer cells and is efficacious in multiple cell lines and animal models of cancer including leukemia, lymphoma, ovarian, pancreatic, breast, non-small cell lung, and melanoma,” says Dr. Frattini, director of research for the hematologic malignancies section. “It inhibits cellular DNA replication at the earliest stages and triggers a series of events that result in the death of the cancer cell.”

The blood and marrow transplantation program is undergoing a major expansion with a new 18-bed inpatient unit opening in February 2014. Dr. Mapara, the director of the program, is leading preclinical and clinical investigations to prevent graft-versus-host disease, the complication of bone marrow transplantation that occurs when the donor cells attack the host’s body. One molecule that has researchers’ attention is called STAT1. “If you inhibit STAT1 on the donor side, you can significantly mitigate GVHD but still allow the transplanted marrow to attack the leukemic cells,” says Dr. Mapara. The transplant program is closely interfaced with related centers at Columbia, including the leukemia and myeloma/amyloidosis services and the Center for Lymphoid Malignancies. Another major focus of the BMT program, in collaboration with the Columbia Center for Translational Immunology and the Columbia Transplant Initiative for Solid Organ Transplantation, is to utilize BMT in combination with solid organ transplantation for the induction of tolerance, which would obviate the need for lifelong immunosuppression. 

Patients of doctors in the multiple myeloma/amyloidosis group headed by Dr. Lentzsch have access to multiple promising new treatments through clinical trials. The clinical and basic research of the program focuses on the optimal combination of novel therapies for relapsed and refractory multiple myeloma. Because amyloidosis is characterized by the buildup of a protein called amyloid that can affect various organs, its treatment relies on close collaboration with other researchers and specialists. Dr. Lentzsch is leading the Columbia Amyloidosis Multidisciplinary Program (CAMP), an international and national referral center for the diagnosis and treatment of amyloidosis that utilizes experts in cardiology, nephrology, neurology, and pathology to develop a tailored, multidisciplinary approach to patient care. “Since different organs can be affected by amyloids, you need the other doctors who have expertise in those areas,” she says.

Myelodysplastic syndrome patients obtain the most precise and personalized care possible—including genomic analysis. “It is incumbent upon us to use every technological advancement and expertise that we have at our disposal to determine the best way to treat each individual patient,” says Dr. Raza. “Here, we have a passion for research—but even more than that, compassion for the patient.”

— Keely Savoie

Contact the Center for Blood Cancers at www.columbiabloodcancers.org or call 212-305-5098