As leaders in hematologic oncology, stem cell, and bone marrow transplantation and immunotherapy, Duke Cancer Institute’s Hematologic Malignancies and Cellular Therapy (HMCT) disease group is internationally recognized for its novel approaches to treating leukemia, lymphoma, myeloma, and other life-threatening blood-related cancers.
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We promote health and improve lives by preventing, diagnosing, and treating blood cancers through integrated, innovative, and holistic patient care, education, and research. We offer a broad selection of treatment options, including access to national and investigator-initiated clinical trials.
The Duke Hematologic Malignancies & Cellular Therapy research program conducts basic, translational, and clinical research. The overall goal is to improve outcomes for patients with hematologic malignancies. We strive to build on and extend the current knowledge in the fields of leukemia, lymphoma, myeloma, hematopoietic cell transplantation, and immunotherapy, and to develop and implement novel strategies for improving therapeutic results in these patients through a collaborative and integrated approach involving all the investigators in the program.
Our research program can be broadly divided into the following research areas:
Basic research into the tumor microenvironment, bone marrow niche
Basic understanding of immunity, both innate and adaptive
Genomics, including a genomics core
Cellular therapies such as hematopoietic stem cells, adoptive immunotherapy with selected T cells, NK cells, dendritic cell vaccines, gamma delta T cells
Graft-versus-host disease and graft-versus-leukemia effects
Cell signaling pathways in normal and tumor cells
Specific Aims
To understand hematopoietic stem cell biology and optimize stem cell graft for allogeneic and autologous stem cell transplantation;
To understand the basic biology of graft versus tumor (GvT) and graft versus host disease (GvHD), and to improve GvT without significant GvHD;
To understand the biology of T, B and NK cells and develop novel immunotherapeutic strategies;
To develop genomic signatures for hematologic malignancies and understand mechanisms underlying leukemogenesis or lymphomagenesis;
To design and execute novel Phase I and Phase II clinical trials in hematologic malignancies based on novel laboratory discoveries within the program.
Focus Areas
Hematopoiesis
Immunity
Leukemogenesis & Lymphomagenesis
Clinical Trials
Clinical Trials Results
As a complement to our research efforts, there is also a robust clinical trials office with over 100 active clinical trials specific to hematologic malignancies and transplantation. These range from phase I “first in humans” to randomized phase III studies.
These trials range from securely storing your medical information in an outcomes-reporting registry, to sample repositories, and to national clinical trials and investigator-initiated trials designed to prevent, detect, or treat your underlying disease with the most advanced treatment methods.
Your participation may help you and others in the future.
Some of these trials are only offered at the Duke Cancer Institute. As a result, we offer a broad selection of treatment options to our patients, including some who are not considered candidates for treatment elsewhere. Your participation in a clinical trial may help you and others in the future.
Hematologic malignancies and cellular therapy specialist Ahmed Galal, MD, FRACP, MSc, consults with a patient at the Duke Cancer Institute Blood Cancer Center.
In the summer of 2016, three-time leukemia patient Connor McMahon, then 15, enrolled in a clinical trial at Duke of a novel immunotherapy using his own disease-fighting T-cells. While there was a significant risk of life-threatening complications, the Atlanta teen — under the care of Duke pediatric bone marrow transplant specialists Tim Driscoll, MD, and Paul Martin, MD —came through the trial with flying colors and was declared cancer free. In sworn testimony before a U.S. Food and Drug Administration (FDA) panel the following summer, Connor’s father Don McMahon urged the regulatory body to approve the customized investigational therapy Connor received, a chimeric antigen receptor (CAR) T-cell therapy called Kymriah (tisagenlecleucel). Weeks later, Kymriah became the first commercially available gene therapy in the U.S. when it received accelerated approval from the FDA to treat children and young adult patients (through age 25) with relapsed/refractory B-cell acute lymphoblastic leukemia.Natural human T-cells, which help orchestrate the body’s immune response, are often fooled by cancer’s disguises. CAR T-cell therapy gives them the boost they need. Unlike a pharmaceutical with a defined chemical formulation, CAR T-cell therapy is made from a patient’s own T-cells (a type of white blood cell called lymphocytes), which are re-engineered in a lab to produce proteins on their surface called chimeric antigen receptors (CARs). These CARs enable the T-cells, once infused back into the body, to recognize and bind to a specific overexpressed antigen (either CD19 or BCMA) on the surface of cancer cells that’s driving their out-of-control growth. The CARs bind with the antigens — like keys into a lock —deactivating those cancer cells.
In December 2023 and January 2024 Duke Cancer Institute senior leaders surprised three deserving recipients with the coveted DCI Superstar Award in recognition of their achievements and exceptional service in going above and beyond in their work.DCI Executive Director Michael B. Kastan, MD, PhD, and DCI Chief Administrator Robin Famiglietti, PhD, MBA, FACHE, arrived at the three DCI cancer centers with bright gold and shiny black balloons, glittering confetti, “You’re a Superstar” water bottles, and personalized cakes to celebrate the awardees. They read excerpts from the nomination letters and presented each awardee with a special crystal award engraved with their name.Family members of the honorees were invited to join the celebration; being careful not to reveal the news before the big moment. Managers and colleagues, including nominators, arrived to show their support for their teammates.
On October 5, Duke Cancer Institute partnered withOncLive for an "Institutional Perspectives in Cancer" webinar focused on leukemia and lymphoma and chaired byNelson J. Chao, MD, MBA. Chao, along with Lindsay A.M. Rein, MD, Mitchell E. Horwitz, MD, Matthew S. McKinney, MD, and Cristina Gasparetto, MD, covered clinical management of myelofibrosis; chronic graft-versus-host disease(GvHD); novel therapies in diffuse large B cell lymphoma(DLBCL); and novel therapies in multiple myeloma.
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OncLive Institutional Perspectives in Cancer (IPC)webinars, like the OncLive signature State of the Science Summits, are short meetings designed to educate healthcare professionals on the clinical benefits associated with new science driving new thinking in cancer management. Attendees improve their knowledge of novel treatment approaches and leave the event the with confidence and intent to apply state-of-the-art treatment strategies to care for their patients. The webinarsassemble academic and community-based physicians & healthcare professionals across key disciplines from medical and surgical oncology. Faculty serve as specialist experts for these premier and renowned oncology summits, which focus on the most relevant cancer topics to ultimately improve patient care.
For decades, bone marrow transplantation has saved the lives of patients with blood cancers or other inherited or acquired bone marrow diseases. But today, it’s helping more people than ever because medical advances have made the procedure feasible for more patients.
Bone marrow is spongy tissue in our bones that houses the blood stem cells that give rise to red blood cells, platelets, and the workhorses of the immune system, white blood cells. In a bone marrow transplant, stem cells from healthy bone marrow or blood are infused into a patient to do the work of producing blood cells. Patients with certain blood cancers like lymphoma may need a transplant if the chemo or radiation necessary to kill their cancer also kills their bone marrow. In other cases, the recipient’s bone marrow stem cells may be producing blood cells, but those cells aren’t up to the task of recognizing and killing cancer and need to be replaced with stem cells from a healthy donor.
The transplanted cells can come from the patient (collected ahead of time) or from a donor. In the past, patients in need of a transplant had to have a matched donor, meaning that recipient and donor had the same immunologic proteins, called HLA. Otherwise, the donor cells would launch an immune attack on the recipient’s body.
Over the last few decades, researchers have made significant progress in discovering how to perform transplants using donated cells that aren’t a perfect match. Furthermore, stem cells can now be harvested not just from bone marrow but from blood and umbilical cord.
“More patients can benefit from transplantation now because there are more donor options,” said Edwin Alyea, MD, the chief medical officer of the Duke Cancer Institute. “And we can now offer reduced intensity transplants, with lower-dose chemotherapy, to patients who were previously not eligible because of age or other medical problems.”
Duke Cancer Institute Blog
Former patient Kameron Kooshesh speaking at his 2022 Harvard-MIT Health Sciences and Technology graduation.
In 2006, 12-year-old Kameron Kooshesh temporarily moved from California to Durham with his parents so that he could get a bone marrow transplant with Duke’s Joanne Kurtzberg, MD. He had just undergone three years of chemo for acute lymphocytic leukemia, and his cancer had returned. His mom researched pediatric bone marrow transplant programs nationwide and chose Duke for her son.
Kooshesh quickly bonded with Kurtzberg and others on his team, from physicians to nurses to case managers. “They knew me and my family so well,” he said. “We trusted them as we would a family member. Duke felt like my home.”
Kooshesh’s bone marrow transplant initially went well, but he developed severe graft versus host disease (GVHD) that didn’t respond to standard treatment. Kooshesh knew of some other kids who had died from GVHD and wondered if the end had come for him.
>Kurtzberg was aware of a drug that might help, but it was still in clinical trials. She won a compassionate-use authorization from the Food and Drug Administration. “Just a couple of infusions of this drug, and I was cured,” he said, “truly cured.” Kooshesh believes he wouldn’t have gotten that drug if he’d been treated at another institution. “Dr. K. is absolutely unbelievable,” he said. “She has a mastery of basic science and clinical and translational medicine that few others have.”
Kooshesh graduated from Harvard Medical School in 2022 and is now a resident in internal medicine at Massachusetts General Hospital. He plans to devote his career to improving stem cell transplants and reducing GVHD.
“I now do the exact kind of research that served as the basis for the drug that saved my life,” he said.
Ovester Grays, athletic director and head women’s basketball coach at Hillside High School in Durham, North Carolina, was diagnosed with mantle cell lymphoma in 2019. Through his nine months of treatment, his entire care team at Duke reassured him. “I was confident about the facts, but the emotional and the mental was nurtured every single step of the way. And it changed my life,” he said. “I’ve told my family if I’m every seriously sick, take me to Duke Hospital. They’re some of the best trained medical treatment personnel in the world. So they mean the world to me.”
When Alexa Balthazar was diagnosed with leukemia at age 28, she ultimately needed a bone marrow transplant. Knowing that her transplant physician, Mitchell Horwitz, MD, had a plan was very encouraging, but she still faced a whirlwind of emotions. Teen and Young Adult Oncology Program nurse navigator Jackie Balliot, BSN, RN, OCN, was there to help. She made several referrals, including connecting Alexa to medical family therapist Geoffrey Vaughn, LMFT, ATR.
“What you go through is traumatic, and to be able to talk with someone who is not a family member or friend about very serious topics was helpful for me,” Balthazar said. In May 2023, she celebrated her one-year transplant birthday.
As the 2023 Annual Meeting of the American Society of Clinical Oncology (ASCO) was wrapping up this week, Chief Patient Experience and Safety Officer at Duke Cancer InstituteThomas LeBlanc,MD, MA, MHS, FAAHPM, FASCO,was already in planning mode for next year's meeting.LeBlanc,a Fellow of ASCOwho's been volunteering with the society for a decade, has been designated chair of the ASCO Annual Meeting Education Program Committee.This prestigious appointment comes as the new president of ASCO, Lynn M. Schuchter, MD, FASCO, pledges to focus her presidential year on “The Art and Science of Cancer Care: From Comfort to Cure” whose key goals include a focus on palliative and supportive care."Under his leadership as an expert in palliative care and quality of life, we are developing educational sessions for the 2024 ASCO Annual Meeting that will include presentations by experts in symptom management, palliative care, and how to have effective serious illness conversations with patients about goals of care," said Schuchter, speaking about LeBlanc, inan interview with The ASCO Post."Incoming President, Dr. Lynn Schuchter, has chosen a presidential theme that is all about the continuum of care, including palliative and end-of-life care issues as well as exciting curative treatments, so we’ll be working together to integrate that type of content much more across the whole conference than in prior years," said LeBlanc. "Palliative care integration in cancer care has been my life’s work, so I couldn’t pass up the opportunity to infuse it into the world’s largest oncology conference!"
Duke Cancer Institute Blog
Cristina Gasparetto, MD, and her patient Thomas Goode, at a Multiple Myeloma cycling fundraiser.
Duke Cancer Institute multiple myeloma specialistCristina Gasparetto, MD, and her patient Thomas Goode, have a candid conversation, in four parts, about the physician-patient journey — from Thomas’ multiple myeloma diagnosis 16 years ago to the present.The journey includes building a strong relationship to support struggles and successes and a path to the future.
This "Mye Journey" series is presented by Duke Cancer Institute and is funded by Multiple Myeloma Research Fund donations.
Duke Cancer Institute Blog
Duke Cancer Institute Executive Director Michael B. Kastan, MD, PhD, presents medical student Priya Alagesan, BS, with the Robert and Barbara Bell Award For Basic Science Cancer Research at the 2022 DCI Scientific Retreat.
For the first time since 2019, the Duke Cancer Institute Scientific Retreat was held in person with a full program followed by a poster session and mingling. Held on December 2, 2022, the retreat attracted around 90 faculty, staff, and trainees (students, residents, fellows, postdocs, etc.).There was also a virtual option, which an additional 184 individuals took advantage of — whether out of convenience or caution during a season of rising Covid-19, Flu, and RSV infections.“Good afternoon, everybody. It's a pleasure to welcome you to the ninth annual Duke Cancer Institute Scientific Retreat. It's wonderful to be able to be in person again. I know this is a hybrid meeting, so we don't have everyone here. Maybe 15% of the audience is in person — but this is better than zero," said Executive Director of Duke Cancer Institute and host of the event Michael B. Kastan, MD, PhD. "We have a wonderful afternoon planned with selections of the top abstracts from each of the Cancer Center programs, a faculty presentation by Dr. Epplein that we're very much looking forward to, and then our keynote speaker for the Colvin lecture, Peggy Goodell from Baylor will be wrapping up the afternoon prior to the poster session.”Commemorations of DCI's 50th Anniversary as a National Cancer Institute-designated Comprehensive Cancer Center were in evidence in nearly every presenter’s PowerPoint — emphasizing their pride in the tremendous impact of current and former DCI investigators and clinicians on cancer research and patient care in the U.S. and around the world.Seven DCI Trainee Members — one from each of DCI's seven basic, clinical, and translational National Cancer Institute-Designated Research Programs — were selected by program leaders and the scientific review committee to present their research at the retreat. (Previous to the retreat all trainees were invited to submit, for oral-presentation consideration, an abstract on their research project).Six of the trainees received a $1,000 award from the DCI and the trainee with the most innovative basic-science research project, as is customary at the annual retreat, received the Robert and Barbara Bell Basic Science Cancer Research Award in the amount of $5,000.Each trainee was introduced by either their mentor or a research-program faculty leader and took questions after their presentation. Between affirmations, friendly critiques, probing questions, and ideas for further exploration, there was no debating that the learning was infectious.In three presentations, the learnings were literally “infectious.”Meira Epplein, PhD, MS, MA—co-leader with Katherine Garman, MD,of the National Cancer Institute-designated DCI Cancer Risk, Detection and Interception Research Program (CRDI) — plus two of seven top trainees addressed, each from different angles, the bacterial and viral associations with and molecular drivers of gastric cancer, and potential strategies for both treating it and stopping its development before it starts.Other topics of the afternoon included:a patient experience study on barriers and facilitators to care in Black patients with newly diagnosed leukemia (specifically AML);a pathology/immunochemistry computational mapping study — deep learning — to characterize the features of the immune micro-environment landscape;novel approaches for: targeting fusion-driven rhabdomyosarcomas; targeting glioblastoma stem cells, otherwise known as brain-tumor initiating cells; and making breast cancer more receptive to treatment with immunotherapies by using targeted therapy/vaccinationand a review, by the keynote speaker, of the mechanisms that regulate hematopoietic stem cells and how they go awry in blood cancersGastric Cancer in Focus