2012 Student Research

Our Dana-Farber Experience

Deirdre Foley & Matthew Murphy

Our Dana-Farber Experience• Dr O Gorman (MIRT Mater Institute of Blood Cancer Research and

Therapy) and Dr Anderson (Dana Farber Cancer Institute, Boston)• Dr McCann – Student Summer Research Awards

• 6-weeks student elective at DFCI – mixed clinical and research experience

• 1. Multiple Myeloma out-patient clinics• 2. Oncology ward rounds at Brigham & Women’s hospital• 3. Shadowing researchers in Dr Anderson’s lab• 4. Development of own personal research projects

1. Analysis of Tumour Marker Expression, Karyotype and Cytogenetic Mutations in Patients with Multiple Myeloma at Dana-Farber Cancer Institute Matthew Murphy• Our aim: To analyse the Tumour markers and Cytogenetic profiles of

patients with MM at DFCI.

• Method: Data on 226 patient cohort with MM at DFCI collected. Analysis of the bone marrow aspirates taken for Flow Cytometry and Fluorescent In-situ Hybridisation (FISH) Cytogenetic Profiling was carried out.

• Results: Relative frequency of Tumour markers and Cytogenetic mutations seen in tables.

• Now that data has been collected for this specific cohort, collection of the patients’ circulating tumour cells (CTC) and analysis of the genetic mutations present in CTC will allow us to understand the pathology behind what makes MM cells metastasise.

• Of particular note a closer analysis of p53 mutation may be interesting to compare as previous data suggest that p53 is key to metastasis.

Flow Cytometry & FISH Studies - ResultsFlow Cytometry- Tumor Markers

0 20 40 60 80 100 120 140 160 180 200

CD3+CD5+

CD3+CD4+CD3+CD8+CD3+CD7+

CD2+CD7+

CD16+CD56+CD57+

CD3+CD94+CD19+CD20+

CD19+CD5+CD19+CD10+CD19+CD23+

CD19+CD11c+CD19+CD43+CD19+CD38+

CD19+Kappa+CD19+Lambda+

CD19+CD25+CD19+CD103+

CD19+CD52+CD22+

CD38+CD138+CD38+CD56+

CD138+CD56+CytoKappa+

CytoLambda+CD45+CD34+CD14+

HLA-DR+CD33+CD13+

CD11b+CD117+

TdT+CD10+CD15+CD61+CD64+

Glycophorin+

Positive Negative

FISH Cytogenetic Profiles

0 10 20 30 40 50 60 70 80

379

1511

13q--13

17p--17

t(11;14)-14q32t(4;14)-16q23t(6;14)

t(14;20)16q-11q-

121p1q

4+6p

18

Abnormal Normal

2. Occurrence of Extra-Medullary Disease in Multiple Myeloma – Analysis of a patient cohort at Dana Farber Cancer InstituteDeirdre Foley

• Collection of data from patient files (n=14)

• Focus on- 1. PET-CT reports since diagnosis of Multiple Myeloma – EMD?

2. Plain film radiographs – Lytic bone disease?

3. Laboratory values at diagnosis• Haemoglobin• Creatinine• Serum Calcium• Beta-2 microglobulin

.

Results-

• Most common sites of disease were Intra-abdominal and Sub-Cutaneous.

• Correlation between bony plasmacytomas, lytic bone disease, and severity of Extra-medullary disease

View of plasmacytoma under microscopy -(http://en.wikipedia.org/wiki/Multiple_myeloma)

Radiograph of the skull demonstrating a typical lytic lesion in multiple myeloma –(http://emedicine.medscape.com/article/204369-overview )

Our Dana-Farber Experience• Educational experience - Multiple Myeloma and other

haematological malignancies in a both clinical and lab based environment

• Novel therapeutic agents – bench to bedside care• Importance of international links• Necessity of research in medicine• Medicine in an international setting - differences in practice in

US v Ireland

Time-out

Thank you to Dr O’Gorman, Dr Anderson and the Myeloma team at DFCI