More than 1,200 British Columbians are diagnosed with a form of lymphoma each year.
Lymphomas are cancers that start in a type of white blood cell called lymphocytes, which circulate primarily through the lymphoid system. The lymphoid system is part of the immune system, which protects against infection. There are many types of lymphomas and together they are the fifth most common cancer diagnosed in Canada.
In general, a large percentage of lymphomas are very treatable. But for some patients current treatment does not result in a long-term cure and BC Cancer researchers at the Centre for Lymphoid Cancer (CLC) are examining molecular and genetic factors to determine why. A key focus of the program is to develop ways to identify at diagnosis those people who have a more aggressive form of the disease in order to better guide treatment approaches.
Progress continues in understanding lymphomas
Some of the research highlights from the Centre for Lymphoid Cancer over the past 10 years are:
- 2007 - A study by BC Cancer researchers provided new evidence that environmental contaminants increase the risk of non-Hodgkin lymphoma.
- 2010 - A never-before-seen DNA mutation was discovered in a gene (EZH2) in diffuse large B-cell lymphoma and follicular lymphoma, the two most common types of non-Hodgkin lymphoma.
- 2010 - Researchers discovered that the number of macrophages (a type of white blood cell) found in Hodgkin lymphoma tumours had a strong correlation to treatment outcome (the greater the number of macrophages, the greater the likelihood that standard treatments would not be successful or relapse would occur).
- 2011 - CLC researchers identified a single gene (CIITA) implicated in two types of lymphoma and described how it defeats the body’s immune system.
- 2011 - A team of BC Cancer researchers identified a significant number of new genetic mutations involved in non-Hodgkin lymphoma by sequencing the genomes of cancer cells from patient samples to search for genetic mutations. The study uncovered 109 genes with recurring mutations, from which 26 have been identified as contributors to non-Hodgkin lymphoma. This study was published in the internationally renowned journal Nature.
- 2015 - CLC researchers showed that vigorous physical activity may lower the risk of developing non-Hodgkin lymphoma.
- 2015 - BC Cancer researchers developed a prognostic test (m7-FLIPI) for follicular lymphoma that identifies those patients at highest risk for treatment failure.
Pursuing a personalized treatment approach
In 2013, Dr. Joseph Connors, clinical director of the Centre for Lymphoid Cancer, launched the Personalized Treatment of Lymphoid Cancer Project.
The project aimed to address the challenge of identifying patients whose lymphoid cancer will not respond to standard treatment protocols, and who might respond better to a different approach.
Over the initial four years of the project, about 670 newly diagnosed lymphoma and leukemia patients were enrolled. Samples of their tumors from all six BC Cancer centres, more than 20 hospitals and multiple physician group practices across the province have been analyzed in BC Cancer laboratories, supervised by Dr. Christian Steidl.
The project revealed a genetic process related to three specific genes (MYC, BCL2 and BCL6) in diffuse large B cell lymphoma that indicates 10 per cent of patients require special, intensified chemotherapy. BC Cancer’s Genetics and Genomics Laboratory now provides this analysis for all patients with diffuse large B cell lymphoma seen in the province. This special chemotherapy program has more than doubled the likelihood of cure for patients with diffuse large B cell lymphoma with that distinct genetic process. Similar insights have emerged from analyses of follicular lymphoma and chronic lymphocytic leukemia.
Donations targeted towards the Centre for Lymphoid Cancer allow researchers to create the infrastructure to sustain projects over time, particularly large-scale projects. These funds also provide seed funding to allow researchers to generate preliminary data for new applications, which can often be the key element that helps secure successful grant funding.