Over the past two years, Lemonade 4 Leukemia raised almost $25,000 to help fund a unique JMML study at UCSF. This study aims to keep children out of transplant by using risk stratification to subclassify them based on DNA methylation. Previously, every child diagnosed with JMML was on an immediate path to transplant. But there is a lot of diversity in the disease course. Transplant itself comes with a high mortality rate, so it is very advantageous to be able to recognize which children may fair well without this aggressive treatment. The study confirms at least three JMML subgroups based on DNA methylation. We also know that there is potential of DNA methylation to subclassify tumors such as glioma, AML, acute lymphoblastic leukemia, chronic lymphocytic leukemia and Waldenstrom macroglobulinemia.
This meta-analysis provides a molecular rationale to define high-
risk patients for whom allogeneic HSCT is not curative and who are, therefore, candidates for clinical trials testing innovative treatment options. On the other hand, there likely exists a subset of patients, characterized by an LM phenotype, for whom a watch-and-wait strategy plus supportive care might be the appropriate intervention.
In summary, this meta-analysis of 255 patients with JMML provides a consensus definition for DNA methylation subgroups in JMML. We have developed a DNA methylation classifier and validated its performance in an independent patient cohort. This classifier allows the prospective identification of DNA methylation subgroups for newly diagnosed patients based on the consensus definition described here. This work will support patient stratification and development of risk-adapted treatment strategies in the context of clinical trials and will improve the comparison of results obtained with different treatment strategies across study groups.
THANK YOU to everyone who bought “a glass of lemonade” from Reese over the past two summers. If you search “Lemonade 4 Leukemia” in the study, you will surely find it listed, and know that your contribution made a difference in this groundbreaking research! We have always known that we are blessed with the greatest community. The gifts of God’s love and the incredible medical staff at UCSF saved Reese. We are forever thankful for the thousands of prayer warriors that held her up for that long journey, and continue to do so today.
We know for a fact that Reese would have fallen into the high methylation, high risk group. Praise God that she is a healthy little 6-year-old girl today!! It is truly our miracle. But there is no doubt that her journey to recovery had to include a bone marrow transplant, and we know that.
How is Reese?
Reese graduated to the STAR program at Lurie. (Survivors Taking Action and Responsibility) I love the word “survivor” and anytime Reese is referred to in this way, my heart sings. Yes, she is a survivor. The oncologists who work at the STAR clinic will follow Reese for life. They know all the tests and potential problems that can arise on her long life journey, and they will be here to support her for all of them. Her first STAR appointment was this past week and her blood looks GREAT. She also received another big round of revaccinations earlier in the week, what a blessing to have the privilege of being healthy enough to receive these vaccines.
We have been very isolated since last March (this time, much like most of the world.) My little girls are used to this and they have adapted well. I know that I will never be sorry I had this extra time with my favorite people. On that note, stay healthy and stay safe. xo